Billing Manager - Jefferson : Job Details

PRIMARY FUNCTION:

• Manage and Coordinate Radiology Coding and Billing: Oversee the accurate and timely coding and billing of radiology services for both hospital and professional services. Ensure that all services are billed according to current regulations and guidelines.
• Volume and Financial Reporting: Assist with the generation and analysis of volume and financial reports. Monitor revenue cycle performance and contribute to financial reporting for radiology-related services.
• Patient Complaint Resolution: Act as a point of contact for resolving patient complaints related to billing and coding. Provide excellent customer service and work to resolve concerns in a timely and professional manner.
• Collaboration with Revenue Integrity & Other Departments: Work closely with the Revenue Integrity department and other relevant departments to address and resolve any coding or billing discrepancies or issues. Ensure compliance with internal policies and external regulations.
• Epic System Input: Provide valuable coding and billing input for the setup of new locations or procedures in the Epic system. Ensure that system configurations align with the billing requirements for radiology services.
• Coordinate with Third-Party Coding Vendor: Collaborate with third-party coding vendors to provide accurate coding guidelines to radiologists and/or management as needed. Ensure seamless communication and understanding between all parties involved.
• Billing/Coding Edit Quality Control: Oversee 7 billing/coding edit work queues (WQs) and review 29 charge router work queues (WQs) to ensure that all edits and charges are processed correctly and efficiently.
• Write-Off Investigation and Improvement: Investigate and work to improve controllable write-offs, ensuring that any avoidable losses are addressed and resolved. Work with the finance and coding teams to minimize unnecessary write-offs.
• Process Improvement Implementation: Define and implement process improvements throughout related workflows and procedures to optimize the billing and coding process. Collaborate with relevant departments to streamline operations and ensure best practices are followed.
• Biannual Conversion of Zero RVU Studies: Oversee the biannual compilation and conversion of zero RVU studies, ensuring that all necessary actions are taken to properly adjust and code these studies.
• Coders Management: Oversee a team of 3 coders, ensuring proper training, adherence to coding guidelines, and accuracy in coding practices. Provide leadership and support to maintain high levels of performance and accuracy in the department.
• Compliance and Regulatory Adherence: Ensure that all billing practices and codes comply with healthcare regulations, including HIPAA, Medicare, Medicaid, and insurance payer policies.
• Continuous Improvement: Stay current on coding updates, billing changes, and industry best practices. Actively contribute to process improvements that enhance billing accuracy and operational efficiency.

EDUCATIONAL/TRAINING REQUIREMENTS:

Broad administrative experience or four years of college BS/BA minimum.

CERTIFICATES, LICENSES, AND REGISTRATION:

Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required.

EXPERIENCE REQUIREMENTS:

Four years in prior health care management position.

Workday Day (United States of America)

Regular

Primary Location Address: 132 S 10th Street, Philadelphia, Pennsylvania, United States of America

Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research.

Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students.

Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region.

Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

At Jefferson, we offer a comprehensive total rewards package designed to support the health and well-being of our colleagues and their families. It includes a wide range of benefits including competitive pay, health and retirement benefits, life and disability insurance, paid time off, educational benefits, financial and mental health resources and much more. Our diverse benefits offerings ensure you have the coverage and access to services you need to thrive both personally and professionally.