124010 Mgr Revenue Cycle

Penn Medicine; Philadelphia (Philadelphia County); On-site; USD 120,000 - 170,000; Full time

Job summary

Penn Medicine in Center City seeks a Manager Revenue Cycle to lead the Surgery Revenue Integrity and Account Resolution teams within the Enterprise Surgery Revenue Cycle. You will oversee charge description master maintenance, systems integrity, education, and KPI reporting to ensure accurate claims submission and optimal revenue capture across professional and hospital services.

Strong leadership, vendor coordination, and a track record in healthcare revenue cycle are essential to drive

Qualifications

• AAHAM Revenue Cycle Certification is preferred.
• AAPC, AHIMA, or RCCB Coding Certification preferred.
• PMP, Six Sigma or other project/process management training or certification preferred.

Responsibilities

• Manages the daily operations of the Surgery Revenue Integrity and Account Resolution divisions within the Enterprise Surgery Revenue Cycle Department.
• Tracks departmental processes and reports to ensure the Revenue Cycle’s KPI benchmarks are being met, and researches, reports, and resolves any variances.
• Assesses, develops, implements, and administers departmental policies and procedures, focusing on continuous process improvement, appropriate onboarding, and ongoing competency-based education.
• Manages an engaged and diverse staff; interviews, hires, assigns and directs work, appraises staff performance with rewards and discipline, addresses complaints and resolves issues that may arise, and acts as a mentor for department staff.
• Oversight of charge description master maintenance, systems integrity and metrics analysis, and revenue capture. Researches and creates strategies and workflows for payment of new and emerging technologies. Coordinates and leads Enterprise Surgery Change Control processes.
• Monitors charge reconciliation, revenue & usage, and other department and health system tools to ensure timely and accurate position of services rendered.
• Works closely with the Surgery Director of Finance, Corporate Revenue Cycle, and supporting teams to proactively identify, research, and resolve any issues or variances in expected volume, revenue, or other KPI measures.
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.
• Other duties as assigned to support the unit, department, entity, and health system organization

Education

High School Diploma or GED AND 10+ years Hospital or Practice Revenue Cycle Setting, including previous supervisory/management experience

Associate's Degree Healthcare, Finance, Management, or related field AND 7+ years Hospital or Practice Revenue Cycle Setting including previous supervisory/management experience.

Bachelor's Degree in Healthcare, Finance, Management, or related fieldAND 5+ years Hospital or Practice Revenue Cycle Setting, including previous supervisory/management experience.

Job description

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Job Title

Manager Revenue Cycle

Department

Surgery Outpatient Chair Billing

Entity

Clinical Practices of the University of Pennsylvania (CPUP)

Location

Centre Square West Tower - 1500 Market Street

Hours

M-F, 8-4:30 with flexibility in hours based on operational need

Summary

• This position is responsible for all Surgery Revenue Cycle front end billing issues, including charge interface, charge description, master dictionaries, billing exceptions and edits, and all contracted payment accounts. The scope includes all professional and hospital Surgery Services (diagnostic, therapeutic, or surgical) performed or billed through Penn Medicine managing approximately 1,500,000 annual patient encounters. The role scope includes oversight of charge description master maintenance, education, systems integrity and metrics analysis, and revenue capture. Oversees teams to ensure established Revenue Cycle guidelines, policies and procedures are followed in order to maintain the integrity of information utilized for scheduling, registration, coding, billing, accurate claims submission and revenue recognition. Researches and creates strategies and workflows for payment of new and emerging technologies. Work with all departments to maintain a high level of charge integrity, maintain expected charge lag, and enhance reimbursement and decrease denials.
• Provides overall support and management of assigned associates with responsibility for quality improvement activities and meeting client/customer/stakeholder service expectations. Directs the efforts of others in the achievement of the strategic and operational objectives of the group. Work with all departments to maintain a high level of patient data integrity, enhance reimbursement, decrease patient wait time, and address any and all patient revenue/reimbursement issues. Administers health system policies and procedures related to areas of responsibility. Determines opportunities for improvement and facilitates process improvement teams to affect change in order to achieve revenue cycle best practices and ensure consistency and compliance throughout Penn Medicine Surgery departments. Manages the hiring, staffing and maintaining of a diverse, engaged, and effective workforce as well as oversight of any applicable vendors. Performance has direct impact on meeting the Revenue Cycle's Key Performance Indicators targets for both the professional and hospital revenue centers.

Responsibilities

• Manages the daily operations of the Surgery Revenue Integrity and Account Resolution divisions within the Enterprise Surgery Revenue Cycle Department.
• Tracks departmental processes and reports to ensure the Revenue Cycle’s KPI benchmarks are being met, and researches, reports, and resolves any variances.
• Assesses, develops, implements, and administers departmental policies and procedures, focusing on continuous process improvement, appropriate onboarding, and ongoing competency-based education.
• Manages an engaged and diverse staff; interviews, hires, assigns and directs work, appraises staff performance with rewards and discipline, addresses complaints and resolves issues that may arise, and acts as a mentor for department staff.
• Oversight of charge description master maintenance, systems integrity and metrics analysis, and revenue capture. Researches and creates strategies and workflows for payment of new and emerging technologies. Coordinates and leads Enterprise Surgery Change Control processes.
• Monitors charge reconciliation, revenue & usage, and other department and health system tools to ensure timely and accurate position of services rendered.
• Works closely with the Surgery Director of Finance, Corporate Revenue Cycle, and supporting teams to proactively identify, research, and resolve any issues or variances in expected volume, revenue, or other KPI measures.
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.
• Other duties as assigned to support the unit, department, entity, and health system organization

Preferred Credentials

• AAHAM Revenue Cycle Certification.
• AAPC, AHIMA, or RCCB Coding Certification.
• PMP, Six Sigma or other project/process management training or certification

Education or Equivalent Experience

• High School Diploma or GED AND 10+ years Hospital or Practice Revenue Cycle Setting, including previous supervisory/management experience
• OR Associate's Degree Healthcare, Finance, Management, or related field AND 7+ years Hospital or Practice Revenue Cycle Setting including previous supervisory/management experience.
• OR Bachelor's Degree in Healthcare, Finance, Management, or related fieldAND 5+ years Hospital or Practice Revenue Cycle Setting, including previous supervisory/management experience.

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.