Description
Purpose:
Coordinate and supervise the processes in both the centralized and decentralized practice sites for: registration, scheduling, coding, charge, and cash posting. Complete financial analysis, projects, evaluations and needs assessments of operational policies and procedures, practices, and computer systems. Provide support, training, development, guidance to CBO staff in their daily activities including reimbursement trends, billing follow up and fiscal calculations. Interact with personnel from Information Services, the CBO, physicians, administrators, and the practice plan to ensure that all operational and revenue needs are met. Analyze, prepare, and present relevant revenue data to CBO management, practice managers/administrators and physicians. Develop solutions to operational problems, create and implement action plans, as well as day-to-day operational revenue management.
Responsibilities:
- Monitor and meet practice specific benchmarks inclusive of point of service and scheduling (inclusive of template management for timely patient access), if applicable.
- Analyze staff development needs and initiates training programs with Education and Training to meet those needs.
- Schedule employee orientation and staff development training.
- Assist management in the formation of quarterly and yearly goals, and in the development and implementation of policies and procedures to support Registration/Scheduling and Patient Business Services operations.
- Provide backup coverage to support daily processes performed during peer vacations, absences, etc.
- Develop and maintain a patient-centric culture, centered around patient arrival and follow-up activities in line with the consumerism initiatives, if applicable.
- Engage in open communications with UPP Management regarding information systems, third-party payer, and regulatory updates and/or enhancements and ensures appropriate training is provided to staff.
- Develops and maintains detailed policies and procedures with coordination of CBO management.
- Communicate with and assist Information Services in the development, implementation, and training of practice management system enhancements.
- Provide analysis and initiate the documentation for the enhancements to the practice management system as required to support the revenue cycle processes, billing, and reimbursement of claims and regulatory changes.
- Investigate, analyze, and recommend actions and solutions for registration, financial counseling, coding, charge entry, cash collection, posting and balancing problems.
- Perform accounts receivable trending on payors and denials, including a calculation for days in accounts receivable and financial analysis on gross and net collections.
- Participate in the recruitment and evaluation of personnel under the direct supervision of the Department Manager. Provide timely performance evaluations.
- Perform random audits of staff work to monitor performance and quality.
- Monitor quality and performance issues; follow up with UPP Management with findings.
- Investigate staff issues and provides feedback as appropriate on resolution.
Qualifications
- Bachelor’s degree preferred with a minimum of 3 years of experience in either information systems, patient business services, or staff development for a professional billing group or other health care environment; or the equivalent combination of education and experience.
- Possess technical and professional skills in healthcare financial management.
- Possess analytical and problem-solving skills, as well as the ability to coordinate the work of others and communicate effectively with the physicians, practice managers, and UPP management.
- Previous supervisory experience desired.
- Knowledgeable of medical terminology, various types of information systems software, electronic data interchange and claims processing, third-party payer rules, reimbursement practices, and regulatory guidelines.
- Prior working experience on personal computers and a variety of office equipment required.
- Willing to travel.
Licensure, Certifications, and Clearances:
- UPMC is an Equal Opportunity Employer/Disability/Veteran
- Individuals hired into this role must comply with UPMC’s COVID vaccination requirements upon beginning employment with UPMC. Refer to the COVID-19 Vaccination Information section at the top of this page to learn more.
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