Manager Mid Revenue Cycle - Hospital Based Inpatient Coding Denials

Advocate Health and Hospitals Corporation•Milwaukee, WI
•Remote

About The Position

The Manager Mid Revenue Cycle will lead and manage daily operations within the assigned function area, ensuring alignment with divisional and enterprise-wide goals. This role involves evaluating processes to improve efficiency, enhance productivity, and support standardized best practices across the Mid-Revenue Cycle. The manager will ensure adherence to regulatory requirements, accreditation standards, and organizational policies, while maintaining confidentiality of patient records. Performance will be monitored using key performance indicators (KPIs) to measure effectiveness, track trends, and implement data-driven strategies for improvement. The role also involves leveraging healthcare technology and analytics tools, collaborating with clinical, IT, Compliance, and Revenue Cycle leaders, and managing and developing a team of professionals.

Requirements

  • Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA).
  • Bachelor’s degree in health information management, Healthcare Administration, or a related field, or equivalent experience.
  • Minimum 8 years of experience in mid-revenue cycle operations, coding, or HIM, including 2+ years of leadership experience in a large integrated healthcare system.
  • Demonstrated knowledge of facility coding, professional coding, and HIM operational guidelines and workflows necessary to scope of work.
  • Understanding of third-party reimbursement programs, state and federal regulatory requirements, national and local coverage decisions, and coding classification systems (ICD-10, CPT, HCPCS).
  • Ability to organize, compile and analyze data from various sources in order to detect patterns, and identify areas for improvement.
  • Strong understanding of EHR systems and other revenue cycle technology solutions.
  • Proficient in Microsoft 365 products, including Teams, SharePoint, Word, Excel, PowerPoint, and Access.
  • Experience in optimizing workflows and improving operational effectiveness within a complex healthcare environment.
  • Skilled in prioritizing business needs and resource management to develop efficient and scalable processes.
  • Proven ability to manage teams, coach staff, and foster a culture of continuous improvement and accountability.
  • Ability to work effectively across multiple departments and within matrix organizational structures.
  • Strong interpersonal skills with the ability to engage clinicians, finance, IT, and revenue cycle teams to align goals, facilitate integration, and drive strategic initiatives.
  • Ability to identify and solve problems creatively, work within deadlines, and maintain a high level of accuracy and attention to detail.

Nice To Haves

  • Hospital Based INPATIENT Coding and Denials Related Experience preferred
  • Certification preferred : RHIA

Responsibilities

  • Lead and manage daily operations within the assigned function area, ensuring alignment with divisional and enterprise-wide goals.
  • Evaluate processes to improve efficiency, enhance productivity, and support standardized best practices across the Mid-Revenue Cycle.
  • Ensure adherence to regulatory requirements, accreditation standards, and organizational policies. Maintain confidentiality of patient records and report any perceived non-compliant practices to leadership or the Compliance Department.
  • Utilize key performance indicators (KPIs) to measure effectiveness, track trends, and implement data-driven strategies for improvement.
  • Leverage healthcare technology and analytics tools to enhance efficiency, support decision-making, and drive innovation in Mid-Revenue Cycle processes.
  • Engage with clinical, IT, Compliance, and Revenue Cycle leaders to integrate Mid-Revenue Cycle processes effectively, ensure regulatory compliance, and promote patient safety. Build and maintain relationships with key stakeholders to drive communication, problem-solving, and operational alignment.
  • Manage and develop a team of professionals by performing human resource functions such as hiring, performance evaluations, and professional development. Provide training, feedback, and career growth opportunities to foster a high-performing and financially responsible workforce.
  • Lead initiatives to improve operational effectiveness, oversee timelines, and drive system enhancements.

Benefits

  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Flexible Spending Accounts for eligible health care and dependent care expenses
  • Family benefits such as adoption assistance and paid parental leave
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program
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