Sr. Manager of Professional Billing Coding

Department
 

BSD UCP - Professional Billing Coding - Medical Specialty

About the Department
 

The University of Chicago Practice Plan (UCPP) is the central organization that supports the clinical activity of nearly 750 clinically active faculty practicing at the University of Chicago. These clinically active faculty collectively form the University of Chicago Physicians Group (UCPG) which is located in Burr Ridge, IL. The University of Chicago Physicians' Group (UCPG) is a component of the physician practice plan for the University of Chicago. The UCPG department provides billing services for medical services provided by University physicians and manages the accounts receivable and reporting processes for the Biological Sciences Division (BSD) departments. Each physician is a faculty member and is based in a specified department in the BSD. The University of Chicago is a private institution encompassing the undergraduate College, six professional schools (Business, Law, Divinity, Public Policy, Medicine and Social Service Administration), four graduate divisions (Biological Sciences, Humanities, Physical Sciences, and Social Sciences) and the University of Chicago Medical Center. The broader University enterprise includes Argonne National Laboratory, Fermilab, and Yerkes Observatory. The Biological Sciences Division (BSD) includes the Pritzker School of Medicine, approximately 20 academic units, degree granting committees, and research centers and institutes. The BSD is located on the University's main campus in Hyde Park, ten minutes south of downtown Chicago. BSD's patient care operations are conducted primarily at the University of Chicago Hospital and clinics, which share the same campus.

Job Summary
 

The job uses best practices and knowledge related to revenue cycle operations, including activities related to charging, billing, and collecting. Coordinates the management of successful billing and compliance activities with department managerial and executive staff.

Responsibilities

• Assesses revenue cycle activities identifying areas of high risk and evaluate risk factors in documentation, coding and billing practices.

• Recommends ways to coordinate, improve, and streamline processes for charge capture, coding, and charge entry, as well as, creates new processes when deemed necessary.

• Manages the charge capture, coding and charge entry process for all departmental on-site and off-site clinic practices.

• Assists Senior Director of Professional Billing to ensure that the department meets documentation requirements and supports all processes involved in accurately posting professional fees.

• Reviews coding procedures and workflow processes and makes recommendations for improvements to the Sr Director of Professional Billing and implements and monitors standard work.

• Manages assigned phases of projects assigned to improve revenue workflows.

• Communicates with the Sr Director of Professional billing regarding the status of specific projects.

• Assists in developing short and long-term goals, as well as policies and procedures for efficient professional billing.

• Manages coders on a day-to-day basis.

• Handles all denials forwarded by UCPG along with the appeal process.

• Analyzes and implements tactics to prevent denials and uncontrollable write-offs.

• Creates and manages reconciliation process.

• Manages process of ensuring outside documentation is entered into EPIC.

• Has a deep understanding in the areas of chart documentation and maintaining requirements within the department. Ensures all processes involved in accurately posting professional fees.

• Has a deep understanding of coding procedures, workflow issues, billing infrastructure, and performance of Clinical Revenue staff. Informs department administrators, physicians, and Coder/Abstractors of regulatory changes.

• Guides departmental compliance efforts by participating in training sessions, performing audits, and promoting an understanding of procedures, policies, and expectations.

• Performs other related work as needed.

Minimum Qualifications
 

Education:

Minimum requirements include a college or university degree in related field.

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Work Experience:

Minimum requirements include knowledge and skills developed through 5-7 years of work experience in a related job discipline.

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Certifications:

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Preferred Qualifications

Education:

• Bachelor’s degree in Health Information Management.

Licenses and Certifications:

• RHIA.