Manager, Physician Billing Revenue Cycle Education and Support - St. Luke's University Health Network
Allentown, PA
About the Job
St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.
The Manager, Physician Billing Revenue Cycle Education and Support analyzes performance metrics and provides consultation, leadership, and direction to enhance front-end workflows and improve revenue performance for St. Luke's Physician Group.
JOB DUTIES AND RESPONSIBILITIES:
+ Maintain current knowledge of Physician Billing and revenue cycle operations
+ Maintains understanding and updates to medical billing policies as it relates to professional billing as well as FQHC’s and ASC’s
+ Knowledge of Charge Reconciliation and processes for training and securing revenue
+ Current knowledge of Strata and Tableau for reporting metrics and KPI’s for financial playbook
+ Collaborates with assigned SLPG leaders for site locations, front office, and billing colleagues to improve revenue cycle performance by reviewing weekly metrics, assessing root cause analysis, and developing/implementing action plans
+ Reviews Front Office Dashboard for significant variances between performance and benchmarks or noticeable drops in performance from week to week
+ Conducts quarterly quality assessment of registration and authorization accuracy performed by front-end users. Provides education and training to those not meeting best practice goals
+ Reviews front end denials (eligibility, registration, and authorizations) for each area and provides feedback to Directors, Practice Managers, and Supervisors. Provides trended metrics to help identify areas that are performing well and areas that need further development/review
+ Oversees, assists, and manages Registration Charge Review and Claim Edit work queues as relates to centralization of Charge Review and Claim Edits
+ Works with Coding Denials Analyst(s) and IT to identify opportunities for optimization and coding education needs for end users and Epic warnings/errors
PHYSICAL AND SENSORY REQUIREMENTS:
Sitting for up to 8 hours per day, 3 hours at a time. Standing and walking as necessary. Fingering and handling frequently, twisting and turning of hands occasionally. Pushing and pulling. Occasionally stoops, bends, squats, kneels and reach above shoulder level. Hearing as it relates to normal conversation. Seeing as it relates to general and near vision.
EDUCATION:
Bachelor’s degree in Healthcare Administration, Business Management and/or 7 – 10 years of professional billing experience required
TRAINING AND EXPERIENCE:
7 years of experience working in Physician Billing, health insurance, physician practice, or similar environment and/or 5 years of previous experience with Physician Billing denials and follow-up. Epic Resolute experience helpful.
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!
St. Luke's University Health Network is an Equal Opportunity Employer. (http://www.slhn.org/EOE)
The Manager, Physician Billing Revenue Cycle Education and Support analyzes performance metrics and provides consultation, leadership, and direction to enhance front-end workflows and improve revenue performance for St. Luke's Physician Group.
JOB DUTIES AND RESPONSIBILITIES:
+ Maintain current knowledge of Physician Billing and revenue cycle operations
+ Maintains understanding and updates to medical billing policies as it relates to professional billing as well as FQHC’s and ASC’s
+ Knowledge of Charge Reconciliation and processes for training and securing revenue
+ Current knowledge of Strata and Tableau for reporting metrics and KPI’s for financial playbook
+ Collaborates with assigned SLPG leaders for site locations, front office, and billing colleagues to improve revenue cycle performance by reviewing weekly metrics, assessing root cause analysis, and developing/implementing action plans
+ Reviews Front Office Dashboard for significant variances between performance and benchmarks or noticeable drops in performance from week to week
+ Conducts quarterly quality assessment of registration and authorization accuracy performed by front-end users. Provides education and training to those not meeting best practice goals
+ Reviews front end denials (eligibility, registration, and authorizations) for each area and provides feedback to Directors, Practice Managers, and Supervisors. Provides trended metrics to help identify areas that are performing well and areas that need further development/review
+ Oversees, assists, and manages Registration Charge Review and Claim Edit work queues as relates to centralization of Charge Review and Claim Edits
+ Works with Coding Denials Analyst(s) and IT to identify opportunities for optimization and coding education needs for end users and Epic warnings/errors
PHYSICAL AND SENSORY REQUIREMENTS:
Sitting for up to 8 hours per day, 3 hours at a time. Standing and walking as necessary. Fingering and handling frequently, twisting and turning of hands occasionally. Pushing and pulling. Occasionally stoops, bends, squats, kneels and reach above shoulder level. Hearing as it relates to normal conversation. Seeing as it relates to general and near vision.
EDUCATION:
Bachelor’s degree in Healthcare Administration, Business Management and/or 7 – 10 years of professional billing experience required
TRAINING AND EXPERIENCE:
7 years of experience working in Physician Billing, health insurance, physician practice, or similar environment and/or 5 years of previous experience with Physician Billing denials and follow-up. Epic Resolute experience helpful.
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!
St. Luke's University Health Network is an Equal Opportunity Employer. (http://www.slhn.org/EOE)
Source : St. Luke's University Health Network