Denver, Colorado
Gainesville, Georgia
Nashville, Tennessee
Braselton, Georgia
Posted: 14-Dec-24
Location: Durham, North Carolina
Categories:
Internal Number: 252722
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke Health's Patient Revenue Management Organization
Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
MANAGER ROLE AND responsibility Manager of Coding Operations-Revenue Operations and Coding Provide leadership and direction to the Department of Ophthalmology, OBGYN, and Emergency Department business lines, including overall responsibility for financial performance in professional abstract coding, trending and processing of coding edits and denials, financial reporting and education to staff and providers. Financial Management: 40% ? Serve as a specialty-specific business owner of defined ProfessionalCodi ng businesslines to include all areas of financial performance; ? Achieve PRMO Balanced Scorecard objectives related to revenue management and coding. ? Maintain strong communication with Director(s) and business partners in reporting unbilled activities related to coding Develop and monitor staff performance standards for productivity and quality? Develop and maintain staffing models to determine FTEs needed to handle workload volumes and accomplish financial performance targets. ? Develop and maintain weekly and monthly KPI reports to summarize staff and outsourcing vendor performance and inventory management aging trends. ? Guide direct reps in identifying deficiencies in staff and A/Rmanagement performance and take action to address outstanding issues. ? Review and approve write-off requests per PRMO policies. Provide feedback to direct reports if write-off requests do not comply with policy requirements.
? Work with vendor agencies to optimize AR performance in support of departmental goals; ? Collaborate with other revenue cycle departments to support all appropriate patient billing, including customer service for patients; ? Identify strategic and creative solutions to improve revenue performance; ? Track and research operational and system issues identified and work with other PRMO divisions to develop/implement solutions for performance improvement. ? Develop and maintain effective working relationships and periodic meetings/communications with fellow managers across the PRMO (registration, ion, billing and collections, finance, IT, and customer service) and within the relevant customer groups to include departmental/specialty-specific revenue managers and business managers to facilitate communication of results and address outstanding issues/concerns. Administrative / Staff management: 30% ? Oversee team efforts in posting, recruiting, and hiring new qualified employees promptly. Approve all new hires and transfers, including sign-off on all compensation decisions. ? Ensure that appropriate orientation and relevant job-specific training are provided to all new and existing employees. ? Ensure that the 90-day probation period, mid-year, and year-end performance evaluations are provided to staff promptly. Review and approve all expectations and expectations evaluations before finalization. ? Provide appropriate orientation and relevant job-specific training to new and existing direct reports. ? Meet one-on-one with each direct report at least biweekly for two-way status updates on performance and associated feedback.
? Review and sign off on PTO utilization by direct reports.? Review and sign off on all disciplinary actions taken for employees on teams under your management. ? Ensure that all direct reports and associated staff comply with all certification and education needs. ? Oversee the development and delivery of job-specific training programs for all staff. ? Identify and implement programs to develop managers/supervisors and associated staff for career development.? Attend team meetings regularly to maintain rapport/contact with staff and be available for questions/issues. ? Maintain an open do or policy to all relevant staff to address employee concerns.? Identify opportunities for improvement of staff morale and develop/implement programs to address those opportunities.
? Monitor specific elements in an annual budget for assigned functions/teams, including OT, education, travel, and contract/vendor labor. ? Review actual vs. budgeted expenses every month and provide explanations of variances to the director, along with an action plan for addressing any significant negative variance. ? Identify opportunities to reduce or minimize personnel and non-personnel costs.? Respond to inquiries from PRMO and DUHS leadership, peers, and staff in a timely, accurate, and comprehensive manner (generally 24-48 hours, depending on circumstances) ? Provide coverage for the director in the defined business line in her absence. ? Provide coverage for Supervisors in their absence. ? Develop and maintain knowledge of all PRMO and DUHS personnel policies, and ensure consistent application of those policies within teams under our management. Technical Expertise: 20% ? Develop and maintain working knowledge of all functions performed by teams under your management, including all Maestro Care WQs and workflows. ? Develop and maintain a working knowledge of all core systems ? Develop and maintain a complete understanding of all workflow processes, internal controls, and operational policies and procedures relevant to teams under your management. ? Keep abreast of regulatory changes related to coding and documentation and communicate these changes to appropriate corporate and hospital staff as an expert in liaison to all compliance and regulation activity in conjunction with P DC and the DUHS Compliance team ? Interacts regularly with physicians, leadership and other associates to ensure compliance and accuracy of coded information. ? Develop and maintain a working knowledge of personal computer software required for fulfilling management responsibilities, including Excel spreadsheets and functions, Wordprocessing, Visio flowcharts, PowerPoint, Service Now, Change Controls, API, I-forms, and SAP Policy & Procedure and Internal Controls
-10% ? Develop and maintain documentation summarizing workflow processes, internal controls, and operating policies and procedures for all functions handled by team.? Document and review all significant changes to operational processes with the director before implementation. ? Ensuring timely and comprehensive completion of all relevant internal controls every month.
Minimum Qualifications
Education
BS Health Information Management, Health Informatics, and Health preferred. Administration, Finance, or related field. A master's degree in Business Administration or Health Administration is
Experience
Six years of experience in the healthcare industry is required; two of the six years are supervising or coordinating coding activities.
Degrees, Licenses, and Certifications
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC).
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.