Coding Manager-Professional Billing

Good Samaritan•Vincennes, IN

About The Position

The Revenue Cycle Manager PB leads and supports the team that performs critical revenue cycle functions for Good Samaritan. These functions include: claims billing/denial management, payment posting, and professional coding. The Revenue Cycle Manager PB develops operational plans to reach established performance targets. This role provides direction to team leaders to maximize performance of all team members and drives forward efficient and effective processes.

Requirements

Professional coding knowledge
Denial management knowledge
Payer guidelines knowledge
Regulatory standards and requirements knowledge
EPIC CT experience
Data analysis skills
Leadership skills
Hiring, training, and evaluation skills
Disciplinary action skills

Nice To Haves

Experience in professional billing, denial management, and payment posting
Experience working with EPIC CTs
Experience in developing operational plans
Experience in maximizing team performance
Experience in driving efficient and effective processes
Experience in interpreting and ensuring compliance with regulatory standards
Experience in identifying issues and improving performance
Experience in using data for decision making
Experience in sharing results with leadership
Experience in cultivating professional relationships

Responsibilities

Provide vision, oversight and direction for all professional coding, denial management, and payment posting (HB and PB) for the professional revenue cycle to achieve departmental goals
Assists with direction and education for patient accounts hospital coders.
Achieve KPI targets for each RCM functional area through increasing department effectiveness and efficiency
Ensure timely and accurate coding and follow-up of all encounters in accordance with the highest standards of billing compliance.
Remain current on relevant areas of knowledge for professional coding, denial management, and payer guidelines and acts as a resource to revenue cycle leaders. Interpret and ensure compliance with regulatory standards and requirements; stay abreast of regulatory requirements, professional standards, and competitive industry practices; and monitor organizational initiatives to maintain service levels and quality.
Identify issues and provide a structured and disciplined approach to defining problems and improving performance, working collaboratively with other leadership within the revenue cycle as well as the Physician Network
Work closely with EPIC CTs to ensure all build is functioning appropriately for clean claim submission.
Uses data to make informed decisions about RCM operations, completes review and analysis monthly of KPI metrics. Demonstrates curiosity and asks questions on trends and encourages team to dig into the details to understand the root cause
Shares results of Revenue Cycle success with the Physician Network Leadership as well as Senior Leadership for Good Samaritan
Direct the activities of revenue cycle supervisors to help hire, train, evaluate, and perform disciplinary actions HR guidelines.
Cultivate and maintain professional relationships with key internal and external stakeholders
Creates and promotes a culture of continuous improvement