The Ambulatory Surgical Center PRMO Revenue Manager serves as a liaison among PRMO, operational owners, and Maestro Care clinical and billing analysts to assist in the design, development, maintenance, training, and evaluation of assigned Maestro Care clinics and business systems to support the revenue cycle. This position will be primarily responsible for the design and re-design of workflow, working with the Meta Care Build teams, and testing, and validating application functionality specifically related to charge capture and billing. This position will coordinate all revenue cycle issues that arise for their application and they must be very knowledgeable of DUHS/PRMO policies, procedures, and business operations.

Revenue Management

Key Accountabilities

• Manage revenue cycle-related inquiries.
• Serve as a point-person/Service Line Resource (Liaison) for Duke ASCs.
• Respond, research, and resolve cycle-related inquiries about assigned Maestro Care app licenses.
• Must be able to communicate effectively, provide timely responses, and identify resources to resolve inquiries.
• Monitor and manage key performance indicators.
• Independently complete data analysis.
• Monitor and manage reimbursement changes.
• Interpret and implement items communicated through your policies.
• Provide training on charge capture, reconciliation, and correction as needed.
• Resolve accounts in assigned Charge Router, Charge Review. Claim Edit and Follow-Up WQs.
• Monitor and manage key performance indicators.
• Utilize standard reports and /or develop new reports to track revenue cycle performance for assigned clinical services.
• Areas of focus will include denial rates, avoidable write-offs,  full transaction write-offs, and deleted charges.
• Will also perform ad hoc analyses as requested, e.g., high-dollar drug reimbursement; service/program/code-specific reimbursement; and actual charge-to-budget charge variance.
• Review key metrics, from scheduling to billing & collections, in collaboration with PRMO managers.
• Identify issues through ongoing monitoring of departmental metrics and/or through routine meetings with key operational managers within PRMO to facilitate communication.
• Monitor & manage reimbursement changes.
• Continuously research and monitor payer regulations; provide education to operational areas.
• As a possible solution, coordinate with DHIP Revenue Managers to educate physicians on how to meet changing payer requirements and regulations.
• their duties as assigned.

Percent of Time

30%

Revenue Cycle Leadership

Key Accountabilities

• Facilitate revenue cycle collaboration and strategic planning activities.
• Serve as Duke Revenue  Cycle Management and Integration Lead for assigned areas to coordinate activities (reduce redundancies) and keep senior leadership informed.
• Coordinate and chair revenue-oriented work group activities and meetings.
• Manage communication among PRMO, hospitals, and physician practices.
• Must be able to facilitate meetings of multi-disciplinary teams.
• Arrange revenue cycle training activities.
• Participate in routine meetings with CFOs, AVPs, and Revenue Accounting to provide updates on current revenue cycle issues and priorities.
• Provide service line specifications for strategic planning and priorities to PRMO leadership through Revenue Manager Councils and Operations Meetings.
• Coordinate and chair revenue-oriented workgroup activities and meetings.
• Share operational changes, from PRMO to hospital and physician practices.
• Develop or participate in focused workgroups to address topics such as registration, billing and collections, coding and charge capture, and Maestro Care applications.
• Facilitate discussions and strategies to address operational issues.
• Managing communication between PRMO and Hospital Operational Owners and Providers.
• Organize and lead workgroups to routinely meet with organizations regarding PRMO function, issues, trends, etc., affecting revenue cycle performance.
• Actively participate in service line-specific strategic planning around revenue cycle prioritization and planning.
• Arrange revenue-cycle training activities.
• Maintain exceptional customer service, fortifying expectations of consistent consistent professionalism and expertise.
• Must be capable of setting priorities and working under pressure.
• Coordinated activities are expected to be carried out with minor supervision.
• Escalate issues as needed.
• their duties as assigned.

Percent of Time

30%

Project Management

Key Accountabilities

• Manage and prioritize revenue and/or compliance requests.
• Manage projects simultaneously.
• Develop and manage action plans and maintain timelines.
• Organize and keep deadlines.
• Identify and recruit appropriate resources.
• Develop and maintain strong relationships.
• Develop creative solutions.
• Must be process-oriented.
• Manage Annual CPT Updates: Coordinate, working  with Health System Operations Managers in assigned applications: DUHS Re-Venue Management and PRMO 

        CDM Team, Hospital Finance, and PDC Revenue Managers, including Annual review of charges and DEPs.

• Investigate and manage revenue opportunities identified through reporting and analysis.
• Other duties as assigned.

Percent of Time

30%

Epic Systems Advisory

Key Accountabilities

• Specialize and manage revenue cycle functions and Epic Systems applications.
• Manage assigned servers Now tickets.
• Must be able to investigate and claim information and navigate information systems.
• Serve as an EPIC System knowledge source for charge capture functions (charge capture, reconciliation, and corrections for procedures, medications, and supplies as appropriate) with specific applications.
• Other duties as assigned.

Percent of Time

10%

Minimum Qualifications

Ideal candidates will be able to balance the above tasks while maintaining flexible, friendly interaction with Operational and Hospital Leadership. The ability to work independently, proactively, and adapt appropriately to changing priorities is a must.  

ASC operational and billing experience is extremely preferred.

Education

bachelor's degree required. M.A.'s degree preferred.

Experience

At least 6+ years of relevant healthcare experience preferred in Charge Integrity is required.

Strong leadership capabilities include the demonstrated ability to lead, motivate, and collaborate effectively with Hospital leadership.

Strong oral and written communication skills.

ASC operational and billing experience is extremely preferred.

Degrees, Licenses, and Certificates

Coding certification (e.g. CCS, CPC, RHIA, RHI T), HFMA CHFP (Certified Healthcare Professional), and CRCR (Certified Revenue Cycle Representative) preferred.