Manager, Coding and Charge Capture

Position Description:

Every day, in ways both big and small, the Medical College of Wisconsin (MCW) is impacting lives for the better. MCW … changemaking for a healthier Wisconsin. 

In the role of Manager, Coding and Charge Capture you will work independently under the direction of the Coding and Charge Capture Director, provide direction and guidance to the team to facilitate the achievement of the project goals. This position is responsible for ensuring that MCW complies with all applicable billing and clinical documentation rules and regulations affecting MCW’s clinical mission.

Responsibilities: 

• Leads, develops and administers Optum’s ClaimsManager application to work in concert with EPIC. Represents MCW while working with Optum for the business assessments. Coordinates with MCW IT and connected hospitals for maintenance and urgent updates as needed. Monitors system changes and plans for updates. Trains support personnel. 
• Works directly with Directors, Department Administrators, Reimbursement managers, Charge Capture managers, CC supervisors, Compliance, QA staff and coders on editing solutions and system capabilities for Healthcare Industry changes. 
• Subject matter expert in build maintenance for Charge Review, Charge Router, Fee Schedules, Insurance follow-up, training, and claims. Serves as a liaison between Charge Capture and CIS. 
• Coordinate and manage project activities including acting as a liaison with internal and external partners.  
• Attend Optum information product related technical and operation calls and conferences to understand newly release build items and analyze, implement, as necessary.
• Coordinate quarterly KnowledgeBase updates with MCW IT and both hospitals. Test changes in real time and sign off after reviewing outcomes. Evaluate newly delivered rules for use.
• Download and activate bi-weekly LCD files from the Optum portal and upload/import and active into the LCD portion of the application. 
• Work with MCW IT on the Technology Support Matrix for our version including browser, operating system and database structures underlying the CM application.
• Create system overrides and timely updates to the CM application corresponding to industry changes including off-cycle changes (eg new COVID codes) to keep charges flowing.
• Add rules/flags or suppress flags in response to repeated force resubmission scenarios with feedback from coding staff or new requests.
• Able to recognize issues and determine priority. Able to quickly isolate and independently resolve issues utilizing all available resources. Able to proactively prevent issues from occurring again and to anticipate future issues.
• Represents MCW while working with business and hospital affiliates regarding systems configuration, and testing. 
• Acts as a liaison between Epic Revenue Integrity Team, CPS Charge Capture and Billing & Collection staff.  
• Manages, leads, facilitates and participates in quality improvement teams / committees and workgroups enhance accurate and timely professional services charge capture. 
• Other special projects involving efficiency in billing and collection processes. 

Knowledge – Skills – Abilities

Expertise in writing and executing integrated test scripts for the full spectrum of the revenue cycle (scheduling/registration/charges/coding/billing/claim).
Experience in knowledge transfer and documentation of system build, testing, and end-user acceptance.
Knowledge of computers, electronics, digital media, databases, applications, software development, risk management, and information security.
Able to effectively communicate in both written and verbal form to customers and management.
Skill in active listening to accurately diagnose end user issues; problem solving and “can do” attitude.
Ability to earn trust and respect across multiple organizations.
Knowledge of technical, business, consultation, project management, and cultural awareness.
Customer focus, building trust, communication, critical thinking, and influencing skills. 

Preferred Schedule:
Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs.

Position Requirements:

Minimum Qualifications:

Appropriate experience may be substituted for education on an equivalent basis

Minimum Required Education: Bachelor’s degree

Minimum Required Experience: 8 years’ experience in multi-payer physician reimbursement with equivalent size scope.

Certification: Applicable Epic certifications preferred in charge router, coding and/or healthcare compliance (RHIA, RHIT, CPC, CCS-P, CHC). 

#LI-RT1 

Why MCW?

• Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
• 403B Retirement Package
• Competitive Vacation and Paid Holidays offered
• Tuition Reimbursement
• Paid Parental Leave
• Pet Insurance
• On campus Fitness Facility, offering onsite classes.
• Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc. 

For a full list of positions see: www.mcw.edu/careers  

For a brief overview of our benefits see: https://www.mcw.edu/departments/human-resources/benefits

Eastern Wisconsin is a vibrant, diverse metropolitan area.  MCW is intent on attracting, developing, and retaining a diverse workforce and faculty body that reflects the community we serve. We value diversity of backgrounds, experience, thought, and perspectives to advance excellence in science and medicine.  MCW is a welcoming campus community with a strong culture of collaboration, partnership, and engagement with our surrounding community. For more information, please visit our institutional website at https://www.mcw.edu/departments/office-of-diversity-and-inclusion . 

MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination
The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering a diverse community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.

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