Revenue Cycle Manager

Department
 

BSD UCP - Revenue Cycle - Revenue Capture

About the Department
 

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.

Job Summary
 

The Clinical Revenue Manager is a member of the Pre-AR Team and provides oversight/management for coding-related charge and claim edits through regular review processes that ensure the appropriate level of accuracy for edits and also identify trends that need further research or education. The Clinical Revenue Manager is the point person for questions related to coding edits, promptly resolving and addressing customer's questions and concerns. Our customers include employees of UCPG as well as employees within the Clinical Departments for whom UCPG performs billing. The Clinical Revenue Manager is also responsible for identifying systemic and training opportunities that reduce edits and denials through problem resolution.
In addition, the Clinical Revenue Manager serves as a procedural and diagnostic coding expert for UCPG and Clinical Department billing staff. The position is accountable for ensuring adherence to correct coding conventions including compliance with HIPAA Code Sets and for maintaining up to date knowledge of all government and third party payer requirements regarding correct coding. This position enhances efficient revenue cycle operations by providing Coding knowledge and expertise to Pre-Accounts Receivable processes with the goal of preventing claim errors and payer rejections/denials. This position also assists with rejections and denials related to coding issues to both assist with resolution and to recommend front-end processes or edits that will allow the rejection/denial to be avoided. This person will manage the Optum Claims Manager System (Third Party Claim Scrubber Tool) and look for opportunities to reduce denials. This individual will also be responsible for producing analytical reports, analysis, and presentations.

Responsibilities

• Monitor denials that are coding related to understand root cause and identify scenarios where more proactive front-end management would be effective.

• Works with Departments to assist with training for coding related edits and to assist with working edits as needed.

• Oversees charge correction related workflows to identify scenarios where corrections could be avoided; implements changes to support.

• Oversees Coding related rules built in EPIC and Claims Manager to confirm accuracy, working closely with IT for resolution.

• Identifies upcoming coding or regulatory changes that will affect the professional revenue cycle; works with UCPG Team for successful implementation of changes.

• Participates and may lead training sessions, performing audits, and promoting an understanding of procedures, policies, and expectations in promotion of compliance efforts.

• 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

Experience:

• Several years multi-specialty physician coding experience.

• Previous experience with physician revenue cycle specific to billing and payment of claims with payers.

• Previous experience using physician billing/revenue cycle software and claim scrubber software.

Licenses and Certifications:

• A coding certificate in one of these accreditations: COC, CPC, CPMA, CPCO, or AAPC.

• Current physician coding certification through a nationally accredited body (e.g., AAPC, AHIMA).

Technical Skills or Knowledge:

• Critical thinking skills to review/compare information and form conclusions is required; PC experience and MS Office (Word, Excel, PowerPoint).

​Preferred Competencies

• Thorough working knowledge of government and third part payer regulations regarding reimbursement.

• Proven ability to effectively develop and introduce procedures and processes to others both within Department and with Manager/individuals in other UCM departments.

• Demonstration of effective interpersonal skills necessary to develop effective working relationships with both internal and external customers.

• Demonstrated ability to participate as a member of a work group or team.

• Demonstrated ability to set priorities and to effectively manage completion of assigned duties, with minimal supervision.

• Demonstrated ability to communicate effectively in English, both orally and in writing.

Working Conditions

• Office Environment.

Application Documents

• Resume (required)

• Cover Letter (preferred)

When applying, the document(s) MUST  be uploaded via the My Experience page, in the section titled Application Documents of the application.

Job Family
 

Financial Management

Role Impact
 

Individual Contributor

FLSA Status
 

Exempt

Pay Frequency
 

Monthly

Scheduled Weekly Hours
 

40

Benefits Eligible
 

Yes

Drug Test Required
 

No

Health Screen Required
 

No

Motor Vehicle Record Inquiry Required
 

No

Posting Statement
 

Employees must comply with the University’s COVID-19 vaccination requirements. More information about the requirements can be found on the University of Chicago Vaccination GoForward .
The University of Chicago is an Affirmative Action/ Equal Opportunity/Disabled/Veterans Employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national or ethnic origin, age, status as an individual with a disability, protected veteran status, genetic information, or other protected classes under the law. For additional information please see the University's Notice of Nondiscrimination.

 

Staff Job seekers in need of a reasonable accommodation to complete the application process should call 773-702-5800 or submit a request via Applicant Inquiry Form.

 

We seek a diverse pool of applicants who wish to join an academic community that places the highest value on rigorous inquiry and encourages a diversity of perspectives, experiences, groups of individuals, and ideas to inform and stimulate intellectual challenge, engagement, and exchange.

 

All offers of employment are contingent upon a background check that includes a review of conviction history.  A conviction does not automatically preclude University employment.  Rather, the University considers conviction information on a case-by-case basis and assesses the nature of the offense, the circumstances surrounding it, the proximity in time of the conviction, and its relevance to the position.

 

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