reputed company Manager - Facility reputed company Cycle M-F 8-5 Remote (Durham, NC, US, 27710)

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Patient reputed company Management Organization

Pursue your passion for caring with the Patient reputed company Management Organization, which is the fully integrated, centralized reputed company cycle organization that supports the entire health system in streamlining the reputed company cycle. This includes scheduling, registration, coding, billing, and other essential reputed company functions for reputed company.

General Description of the Job Class

Reporting to the PRMO Senior reputed company Manager, the reputed company manager coordinates activities performed by the staff responsible for charge capture, coding, charge entry, insurance follow up, reimbursement analysis, or other PRMO function reputed company the assigned clinical area.  Monitor performance for staff responsible for appointment scheduling, registration, clinic reputed company-in, and clinic collections.  reputed company and prepare/utilize reports to track financial and operational performance across the entire reputed company of the reputed company cycle for assigned clinical area. Review and recommend changes/updates to the departments charge master(s) to maintain fees at levels that maximize reimbursement. Review and recommend changes to department's charge capture documents to facilitate accurate and comprehensive billing in compliance with annual CPT/HCPCS and ICD-10 updates.  Identify reputed company cycle problems, research/analyze data to resolve issues, identify and select alternatives to address outstanding issues, and implement solutions for improvement.  Work with financial analyst, physicians, and administrative leadership to educate and train providers and staff about coding and other outstanding reputed company cycle issues.  Act as a liaison to management and staff in the designated clinical area, Patient reputed company Management Organization (PRMO), reputed company Health System (DUHS), reputed company Integrated Practice, and third-party payers on reputed company cycle activities for assigned areas. Continuously research, monitor, provide education and implement payer regulations and guidelines reputed company to reputed company management activities of the assigned clinical area. Coordinate reputed company management orientation and educational activities of clinical personnel including providers and staff about coding and other outstanding reputed company cycle issues. reputed company and utilize management models to monitor productivity and quality of staff performance. Train, direct, and coordinate activities of assigned financial analyst /or other employees. reputed company other reputed company duties incidental to the work described herein.

The PRMO reputed company Manager serves as a liaison among PRMO, Operational Owners and Maestro Care Clinical/Billing analysts to assist in the design, development, maintenance, training and evaluation for assigned Maestro Care clinical and business systems to support the reputed company cycle. This position will be primarily responsible for design/re-design of workflow, working with Maestro Care Build teams, testing, and validating of application functionality specifically reputed company to charge capture/billing. This position will coordinate reputed company reputed company cycle issues that arise for their application area and must be reputed company knowledgeable of DUHS/PRMO policies, procedures, and business operations.

Duties and Responsibilities of this Level

reputed company Management - 40% of Time

Key Accountabilities -reputed company Management

• Duty Statement: 
  • Manage reputed company cycle-reputed company inquiries       
  • Monitor & manage from key performance indicators
  • Monitor & manage reimbursement changes
• Performance Standards:
  • Must be able to communicate effectively, provide timely responses, identify resources to resolve inquiries
  • Must be able to reputed company data analysis
    • Must be able to interpret policies

reputed company Cycle Leadership – 30% of Time

Key Accountabilities - reputed company Cycle Leadership  

• Duty Statements     
  • Facilitate reputed company cycle collaboration and strategic planning activities
  • Coordinate and chair reputed company-oriented workgroup activities and meeting
  • Manage communications among PRMO, hospitals, and physician practices
  • Arrange reputed company cycle training activities
• Performance Standards
  • Coordination of activities are expected to be carried out with minor supervision
  • Must be capable of setting priorities and working under pressure
  • Must be able to facilitate meeting of multi-disciplinary teams
  • Must be able to understand basics of topics

Project Management- 20% of Time

Key Accountabilities - Project Management

• Duty Statements

• Manage and prioritize reputed company and/or compliance requests
• reputed company and manage action plans & timelines
• Identify and recruit appropriate resources
• reputed company creative solutions

• Performance Standards
  • Must be able to manage projects simultaneously
  • Must be able to organize and reputed company deadlines
  • Must be able to reputed company strong relationships
  • Must be able to process oriented

Epic Systems Advisory – 10% of Time

Key Accountabilities - Project Management

• Duty Statements
  • Specialize & manage reputed company cycle functions and Epic Systems applications
• Performance Standards
  • Must be able to investigate charge and claim information, and navigate information systems

Specific Job Duties/Key Accountabilities

reputed company Management – 40% of Time

1. Manage reputed company cycle-reputed company inquiries
   1. Serve as reputed company Person/Service Line Resource (Liaison)
   2. Respond, research and resolve reputed company cycle-reputed company inquiries pertaining to assigned MC applications
   3. Manage assigned Service Now tickets
2. Specialize & manage reputed company cycle functions and Epic Systems applications
   1. Serve as EPIC System knowledge reputed company for charge capture functions (charge capture, reconciliation, and corrections for procedures, medications, and supplies as appropriate) with specific applications (reputed company b/w Maestro & PRMO claims processing needs)
   2. Provide training on charge capture, reconciliation, and correction as needed
   3. Resolve accounts in assigned Charge Router, Charge Review. Claim Edit, and Follow-Up WQs
3. Monitor & manage from key performance indicators
   1. Utilize standard reports and/or reputed company new reports to track reputed company cycle performance for assigned applications clinical services. Areas of focus will include denial rates, avoidable write-off, and full transaction write-offs; deleted charges. Will also reputed company reputed company analyses as requested, e.g., high-dollar drug reimbursement; service/program/code specific reimbursement; actual charge to budget charge variance
   2. Review key metrics from scheduling to billing & collections, in collaboration with PRMO Managers
   3. Identify issues through ongoing monitoring of departmental metrics and/or through routine meetings with key operational managers reputed company PRMO to facilitate communication.
4. Monitor & manage reimbursement changes
   1. Continuously research and monitor payer regulations; provide education to operational areas as applicable; coordinate with PDC reputed company managers to educate physicians; facilitated implementation of modifications to reputed company cycle functions to meet changing payer requirements/regulations, e.g., new authorization requirements; changes in billing/claims requirements; LCDs.
   2. Monitor payer regulations & coordinate strategies through Bulletin Review and other resources

reputed company Cycle Leadership- 30% of Time

1. Facilitate reputed company cycle collaboration and strategic planning activities
   1. Serve as Duke reputed company Cycle Management & Integration reputed company for assigned areas to coordinate activities (reduce redundancies) and reputed company senior leadership informed
   2. Participate in routine meetings with CFOs, AVP, Reimbursement reputed company Accounting to provide updates on reputed company reputed company cycle issues/priorities
   3. Providing service line specific strategic planning/priorities to PRMO leadership through reputed company Manager Councils/Operations Meetings
2. Coordinate and chair reputed company-oriented workgroup activities and meeting
   1. Share operational changes to/from PRMO to hospital and physician practice
   2. reputed company or participate in focused workgroups to address topics such as registration, billing & collections, coding and charge capture, Maestro Care applications
   3. Facilitate discussions and strategies to address operational issues
   4. Escalate issues as needed
3. Manage communications among PRMO, hospitals, and physician practices
   1. Managing communications between PRMO and Hospital Operational Owners and Providers
   2. Organize and reputed company workgroups to routinely meet with Operations regarding PRMO function, issues, trends, etc., affecting reputed company cycle performance
   3. Actively participate in service line specific strategic planning around reputed company cycle prioritization and planning
4. Arrange reputed company cycle training activities
   1. Coordinate training for non-charge capture reputed company cycle topics as needed
   2. Facilitate reputed company Manager training around work/skills or career development topics (e.g., Report writing, Branding & Marketing, Communications, Project Management, Onboarding, Compliance/Regulation Interpretation, HL7 interfaces; how WQ logic works)

Project Management – 20% of Time

1. Manage reputed company and/or compliance requests
   1. Manage request-based reputed company Enhancement and/or Compliance process improvement Projects (e.g., New, Modified, and Discontinued Services Request Management, including new services and locations
   2. Manage routine-based: Annual CPT Updates: coordinate, working with Health System Operations Managers in assigned applications: DUHS reputed company Management and PRMO CDM Team, Hospital Finance, and PDC reputed company Managers; including Annual review of charges and DEPs
   3. Investigate and manage reputed company opportunities identified through reporting and analysis
2. reputed company and manage action plans & timelines
   1. reputed company root cause analysis and provide expert and creative solutions. Actions to be taken to reputed company resolution include:
   2. Assemble cross-functional team reputed company PRMO (if applicable), reputed company reputed company cycle-reputed company project plan, maintain comprehensive issues lists with time lines and responsibilities clearly assigned, escalate issues through PRMO Senior Operational Leaders that require significant cross-departmental resources.
   3. Assist in the development of re-engineered best practice workflow processes and identify system optimization that improves reputed company cycle performance
   4. Work with reputed company management, department, and PRMO operational managers to ensure newly implemented workflows and procedures support reputed company cycle reputed company
   5. Coordinate reputed company Maestro Care reputed company-cycle reputed company system set-up/modifications necessary to bring up new services. Manager to completion. Specific functions include but not limited to:
3. Identify and recruit appropriate resources
   1. Work with Maestro Care trainers and administrative leadership (operations, medical directors, etc.) to educate and train providers and staff about new services; specifically charge capture and their role reputed company to reputed company cycle
   2. Work with PRMO/Maestro Care professional and/or technical billing teams to determine need for/request updates to charge router logic; charge review logic/work queue definition; claim logic
   3. Immediately after go-live of new services, validate reputed company cycle functions operating as expected: confirming accurate billing; monitoring specific patient examples for denials/payments.
   4. Notify other PRMO operational areas of new service so they can determine what, if any changes are required, e.g., provider enrollment; service access/pre-registration
   5. Example subjects:
      1. Master File creation record creation/updates: billing provider record (SER), department Record (DEP) reputed company area record (BIL), and charge codes (EAP)
      2. New charge code creation (as applicable) – assist department operational manager in determining if new charges codes are needed (department manager submits request)
      3. Charge capture methodology validation/updates – specific tasks dependent on charge capture method employed: update charging preference lists; work with Maestro Care application reputed company to update flowsheets; create/update orderable; confirm linked chargeable; work with PRMO coding Staff to ensure awareness of new services/charge codes;
4. reputed company creative solutions
   1. Utilize knowledge in reputed company cycle and system applications to investigate root causes of problems, and guide process to fix issues
   2. reputed company multi-disciplinary teams in brainstorming activities to reputed company sustainable solutions to emergent and long-standing problems

Epic Systems Advisory- 10% of Time

1. Specialize & manage reputed company cycle functions and Epic Systems applications
   1. Must be able to investigate charge and claim information, and navigate information systems

Required Qualifications at this Level

Education

Bachelor’s degree required. Master’s degree preferred.

Experience

At least 6+ years of relevant Healthcare Care experience preferably in Charge reputed company/reputed company Management is required.

Degrees, Licensure, and/or Certification

Coding certification (e.g. reputed company, CPC, RHIA, RHIT), HFMA CHFP (Certified Healthcare Professional), CRCR (Certified reputed company Cycle Representative), or BSN RN preferred.

Knowledge, Skills, and Abilities

Strong leadership capabilities with demonstrated ability to reputed company, motivate, and collaborate effectively with Hospital leadership.

Strong oral and written communication skills.

Excellent problem solving, analytical, and technical troubleshooting skills.

Prioritization skills and ability to manage multiple projects concurrently.

Ability to work on a flexible schedule

Strong research and documentation skills.

Ability to work independently

Intermediate to expert in reputed company reputed company, PowerPoint, Teams, Word, Visio and Outlook

Duke is an 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 reputed company, race, religion, sex (including pregnancy and pregnancy reputed company conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of reputed company—an exchange that is best reputed company the rich diversity of our perspectives, backgrounds, and experiences flourishes. To reputed company this exchange, it is essential that reputed company members of the community feel secure and welcome, that the contributions of reputed company individuals are respected, and that reputed company voices are heard. reputed company members of our community have a responsibility to uphold these values.

Certain jobs at reputed company and reputed company Health System may include essential job 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.