REVENUE CYCLE MANAGER

Company: University of Washington
Location: Seattle
Posted on: January 26, 2023

Job Description:

If you are using a screen reader and experience any difficulty accessing our web pages, please call 206-543-2544 or email UWHires and we will be happy to assist you. jump to content Salary: Salary and benefits are competitive. Salary is commensurate with qualifications and experience. Shift: First Shift Notes: As a UW employee, you will enjoy generous benefits and work/life programs. For a complete description of our benefits for this position, please visit our website, click here. As a UW employee, you have a unique opportunity to change lives on our campuses, in our state and around the world. UW employees offer their boundless energy, creative problem-solving skills and dedication to build stronger minds and a healthier world.

UW faculty and staff also enjoy outstanding benefits, professional growth opportunities and unique resources in an environment noted for diversity, intellectual excitement, artistic pursuits and natural beauty.

The Department of Medicine has an outstanding opportunity for a Revenue Cycle Manager (RCM) to join their team.

POSITION PURPOSE

The Revenue Cycle Manager (RCM) supports the clinical mission of the Department of Medicine. The Department has a very large and diverse clinical operation. This position works to ensure that charges for clinical services are appropriately captured and reimbursed. In addition, this position supports the Department and Division Administration by providing relevant reports and analysis from clinical operations. This position also works with the providers directly by helping to troubleshoot issues with clinical documentation and ensuring that they have access to the necessary resources to be documented in a manner compliant with existing regulations.

This position requires strong analytic and reporting skills including understanding revenue and productivity data elements, identifying the best sources for data, understanding system applications, and assessing how best to extract and report data for intended use. This position assures effective, efficient, and compliant billing and coding activities that support sound business practice and financial stability. The position also requires excellent interpersonal communication skills in providing support to the Department's faculty and administrators.

The Department of Medicine is ranked as a leader nationally and internationally in clinical care, research, and education. This position provides strategic planning, policy development and implementation, operational management, and systematic evaluation and analysis of the Department's clinical programs.

The Department of Medicine is the largest department in the School of Medicine with over 4500 staff, faculty, trainees and students and an annual budget of approximately $425,000,000 consisting of patient care revenue, sponsored research funds, endowments and gifts, state funds and affiliated hospital funding associated with the academic programs within the department. The department is made up of thirteen subspecialty divisions: Allergy and Infectious Diseases; Cardiology; Dermatology; Gastroenterology; General Internal Medicine; Gerontology & Geriatric Medicine; Hematology; Medical Genetics; Metabolism, Endocrinology and Nutrition; Nephrology; Oncology; Pulmonary & Critical Care Medicine; and Rheumatology. These divisions occupy space at multiple sites including University of Washington Medical Center-Montlake (UWMC), Harborview Medical Center (HMC), University of Washington- NW Campus, Veterans Administration Puget Sound Health Care System (VAPSHCS), Puget Sound Blood Center (PSBC), Fred Hutchinson Cancer Research Center (FHCRC), Seattle Cancer Care Alliance (SCCA), and other locations in the Seattle area. UW Medicine is a very complex organization to work within and this position will help support the multiple competing missions.

The RCM will work primarily with the divisions of Gastroenterology, Cardiology and other divisions will be assigned. The RCM works independently as well as part of a team of RCM, each responsible for multiple divisions. The Revenue Cycle Manager works closely with the facility partners in supporting the implementation of new billing applications, on-boarding all UW based faculty practicing with specific training in regard to professional fee billing processes and following up on faculty documentation issues with the UW Department/Division Administrators. This position also provides analysis of performance data with the goal of optimizing clinical practices.

This position has strong analytic and reporting skills including understanding revenue and productivity data elements, the best sources for data, an understanding of the system applications, and how best to extract and report data for intended use. This position assures effective, efficient, and compliant billing and coding activities that support sound business practice and financial stability.

Facilitate the business expectations of the medical centers, division, department, practice plan and physicians so that their organizational goals are focused and aligned.

Serves as the "expert" in UW Medicine clinical procedures and services in order to serve as a reference and provide education and training to ensure optimal and compliant billing practice. This includes the clinical practice sites at UWMC, HMC, SCCA, NWH and the VA.

Must have the knowledge and expertise of the complete clinical revenue cycle with strong analytical and reporting skills including understanding of revenue and productivity data elements, the best sources of data, an understanding of the system applications, and how best to extract and report data for intended use.

This position has a direct impact on the integrity and quality of the clinical care and patient service functions provided in conjunction with the Department of Medicine faculty and for the UW Medicine Health Care System. Effective clinical business practices and compliance directly impacts the mission of exceptional service and operational excellence.

This position will ensure appropriate clinical billing and compliance with federal and state regulations.

This position impacts over 17 million in clinical revenue and will ensure appropriate clinical billing and reimbursement procedures and compliance with federal and state regulations.

DUTIES AND RESPONSIBILITIES

Clinical Business Operations 40%

Clinical Programs Quality and Assurance:

• Monitors coding and charge capture quality.
  
• Monitors performance of set expectations and assigned benchmarks for clinical coding and charge capture.
  
  Data and Process Analysis:
  
  This position will provide strong analytic and reporting skills, including understanding elements of revenue and productivity data, identifying data sources, interpreting system applications, and assessing how best to extract and report data for intended use. This position assures effective, efficient, and compliant billing and coding activities that support financial stability and sound business practice.
  
  
• Regularly reviews billing procedures with physicians, managers, and staff for accurate professional coding of services.
  
• Monitors results of the compliance audits in conjunction with the UWP Compliance Officer, UW Medicine Compliance, and Medical Center compliance.
  
• Monitors and reports performance measured by Work Relative Value Units (wRVUs) against goals.
  
• Serves as a consultant to physicians to help them achieve their individual goals.
  
• Analyzes physician and advanced practice providers' practice models and assists clinical leadership in decisions to optimize practice.
  
• Provides ongoing monitoring of billings and wRVUs to identify problems or to measure the impact of process changes for early intervention if necessary.
  
• Serves as an expert in analyzing billing data and clinical appointment/session data. Produces routine reports that monitor billings, wRVUs, and appointment/session/template activity.
  
  Revenue Cycle Oversight 40%
  
  
• Reviews clinical documentation to ensure that appropriately documents services are captured, and works with providers to correct documentation which is incomplete or inconsistent with current requirements.
  
• Recommends and implements improvements to the revenue cycle that promote efficient and effective processes.
  
• Liaison to physicians, department, practice plans, and medical centers for revenue cycle work process, coding and reimbursement issues.
  
• Ensures input data are highest quality necessary to produce accurate claims and reduce denials.
  
• Partners with department administrators regarding physician schedules, productivity and service standards
  
• Reference for physicians, fellows, residents, medical students, administrators, clinical staff, outside payors, and vendors. This position must translate the clinical procedures and services provided by the physicians to direct optimization of the charge activity.
  
• Responsible for validation of charge input, editing of CPT/HCPCS and ICD10 codes, maintaining adequate controls of the charge process
  
• Provides updates and teaching of appropriate coding, billing and documentation for the physicians, fellows, residents, and other relevant staff.
  
• Follows UWP Physicians security and confidentiality policies and procedures.
  
  Training and Education 10%
  
  
• Develops and implements professional fee billing and reimbursement educational programs to support on boarding of new providers.
  
• Provides ongoing professional fee education covering changes in billing and reimbursement rules, state and federal legislation, and billing software applications.
  
• Monitors/conduct chart reviews and implement intervention strategies as necessary.
  
• Collaborates with UWP professional fee billing specialists to provide annual compliance training requirements, ensuring institutional deadlines are met.
  
• Attends seminars and stays current on the documentation requirements, by both UW Medicine and payors and alerts physicians to changes in the organization and the industry.
  
  Other Duties 10%
  
  
• Provides other data analysis, reporting, and duties as required.
  
  MINIMUM REQUIREMENTS
  
  
• Bachelors degree in Business/Healthcare Administration and/or five years of healthcare experience that demonstrates professional and technical knowledge of health care finance and reimbursement and 4-5 years of experience.
  
  Equivalent education/experience will substitute for all minimum qualifications except when there are legal requirements, such as a license/certification/registration.
  
  ADDITIONAL REQUIREMENTS
  
  
• Demonstrated experience of success in a health care delivery system with an in-depth understanding of clinical practice and revenue cycle management.
  
• Strong proficiency in Microsoft Office Suite including Excel and Access and Databases.
  
• Excellent oral, written and interpersonal communication skill, with the ability to convey a positive, professional image.
  
• Ability to multi-task and work independently, while adhering to strict deadline
  
• Certified Professional Coder Certification.
  
• Demonstrated dedication to equity, diversity and inclusion. Strong interpersonal communication skills.
  
• Must be proficient with Microsoft Excel, Word and PowerPoint.
  
  Application Process:
  
  The application process for UW positions may include completion of a variety of online assessments to obtain additional information that will be used in the evaluation process. These assessments may include Work Authorization, Cover Letter and/or others. Any assessments that you need to complete will appear on your screen as soon as you select "Apply to this position". Once you begin an assessment, it must be completed at that time; if you do not complete the assessment, you will be prompted to do so the next time you access your "My Jobs" page. If you select to take it later, it will appear on your "My Jobs" page to take when you are ready. Please note that your application will not be reviewed, and you will not be considered for this position until all required assessments have been completed.
  Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law .
  
  Committed to attracting and retaining a diverse staff, the University of Washington will honor your experiences, perspectives and unique identity. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable and welcoming.To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 or dso@uw.edu .COVID-19 VACCINATION REQUIREMENTGovernor Inslee's Proclamation 21-14.2 requires employees of higher education and healthcare institutions to be fully vaccinated against COVID-19 unless a medical or religious exemption is approved. Being fully vaccinated means that an individual is at least two weeks past their final dose of an authorized COVID-19 vaccine regimen. As a condition of employment, newly hired employees will be required to provide proof of their COVID-19 vaccination. View the Final candidate guide to COVID-19 vaccination requirement webpage for information about the medical or religious exemption process for final candidates.

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