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Process Improvement Manager - Revenue Cycle

Weill Medical College of Cornell University

New York, NY
Job Code:
Weill Medical College of Cornell University
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Job Details

Job Title Process Improvement Manager - Revenue Cycle

JobID 3243

Location: New York, NY

Description Position Summary
Responsible for curriculum development and payer guideline communication, training delivery of accounts receivable concepts, policies and procedures, along with continuous process optimization and improvement. This role will also render quality audit controls and technical troubleshooting.
Job Responsibilities
+ Develops programs related to functional responsibilities of revenue cycle services, including billing & insurance follow up protocols, SOPs for effective A/R follow.up insurance liability, Epic application efficiency and operational methodologies.

+ Orients, trains and educates A/R staff on denial management, coding and billing related concepts to achieve training milestones and meet operational goals. Provides continuous quality improvement training and educational opportunities for employees.

+ Reviews on.going issues and workflows and contributes to the development of processes to advance efficient and accurate billing and collection methods such as real.time effectual denial resolution and prevention strategies.

+ Collaborates on the initiation and development of continuous quality improvement by establishing and maintaining policies and procedures, promoting and advising recommendations and implementations.

+ Leads analysis of business and technical problems, and works with teams to create innovative solutions. Identifies root cause topics, trends to resolve and establish continuous quality improvement opportunities to develop and execute.

+ Establishes and executes audit controls measures of quality and quantity audit reviews. Defines and report inconsistencies. Analyzes and troubleshoots problem workflows, identifies potential improvement targets and execute or reinforce training.

+ Assists with the development & implementation of policies & procedures to minimize A/R days. Addresses major charge & billing matters related to claim submissions & trending. Ensures training materials are current & new content is developed as needed.

+ Researches & interprets payer contract terms, creates & compiles necessary supporting documentation templates for appeals according to various payer claim guidelines. Researches & updates policies when new health care laws & regulations are implemented.

+ Establishes the development of a repository for training materials & appeal documentation for easy accessibility. Assists in creating follow up standard of operations for comprehensive understanding of all policies & procedures related to daily workflows.

+ Assists with providing resources of payer policies and guidelines.

+ Participates in the build of prerequisite materials for online/virtual consumption, aids the focus of achieving effective daily productivity standards and recommends new approaches to enhance staff performance and productivity when appropriate.
+ Bachelor's Degree in related field
Approximately 2 years of accounts receivable and coding experience.
Approximately 5 years of experience with multi.specialty physician billing and collections in a large academic medical center with in.depth knowledge of the practice management system.
Knowledge of the billing and submission guidelines for the Medicare, Medicaid, Medicaid Managed, Medicare Managed, Worker's Compensation and No Fault payers.
Work experience in a health care setting .i.e. hospital, physician's office, nursing home, billing agency. with extensive experience using ICD.10 and CPT coding systems, Healthcare Common Procedure Coding System .HCPCS. and the Current Procedural Terminology .CPT. systems of coding to assign codes for services provided to patients.
Approximately 3.5 years of supervisory experience or capacity in a multi.cultural environment.
Demonstrated evidence of highly engaging facilitation skills in a variety of learning environments to ensure effectiveness and accuracy in engaging audiences with diverse skillsets and learning needs. Effectively display the ability to perform and maintain good working relationships within the PO Business Office departmental teams and across all business units fostering a team environment, providing high.level training to the Revenue Cycle PO Business Office staff.
CPMA, CCS, CDEO, CPCO highly desired.
Project management experience with emphasis on process improvement, change management, or implementation of customer/ patient centered processes highly desired.
Certification and/or demonstrated working knowledge of Lean/ Six Sigma principles methodologies highly desired.
Knowledge, Skills and Abilities
+ Excellent communication skills .both verbal and written..

+ Demonstrated ability to coach, train and provide staff development.

+ Demonstrated organizational skills and ability to pay close attention to detail.

+ Skilled in determining strengths and weaknesses in subordinate staff, and able to identify areas for growth. Demonstrated ability to coach, train and provide staff development.

+ Demonstrated ability to multi.task and prioritize in a fast.paced environment.
Licenses and Certifications
Working Conditions/Physical Demands
Weill Cornell Medicine is a comprehensive academic medical center that's committed to excellence in patient care, scientific discovery, and the education of future physicians in New York City and around the world. Our doctors and scientists.faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and the Weill Cornell Physician Organization.are engaged in world.class clinical care and cutting.edge research that connect patients to the latest treatment innovations and prevention strategies. Located in the heart of the Upper East Side's scientific corridor, Weill Cornell Medicine's powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U.S. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey. Our medical practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork.Presbyterian Hospital/Weill Cornell Medical Center, NewYork.Presbyterian/Lower Manhattan Hospital, and NewYork.Presbyterian/Queens. At Weill Cornell Medicine, we work together to treat each individual, not just their conditions or illnesses, as we strive to deliver the finest possible care for our patients . the center of everything we do. Weill Cornell Medicine is an Equal Employment Opportunity/Minorities/Females/Vet/Disabled employer.

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