Mgr Revenue Cycle

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

Benefits offered by this job

Employee benefits program

Job summary

Penn Medicine is seeking a senior leader for the Medicine Revenue Cycle at Penn Presbyterian Medical Center. The role oversees front-end billing operations, charge descriptions, master dictionaries, and revenue capture, ensuring data integrity for scheduling, registration, coding, billing, and claims submission.

Responsibilities include guiding process improvement, staffing a diverse team, and driving KPI performance across professional and hospital revenue centers.

Qualifications

• Bachelor's degree in Healthcare, Finance, Management, or related AND 5+ years Hospital or Practice Revenue Cycle Setting, including previous supervisory/management experience (Required).
• OR Associate's Degree in Healthcare, Finance, Management, or related AND 7+ years Hospital or Practice Revenue Cycle Setting including previous supervisory/management experience (Required).
• OR HSD/GED AND 10+ years Hospital or Practice Revenue Cycle Setting, including previous supervisory/management experience (Required).

Responsibilities

• Manages the daily operations of the Revenue Integrity and Account Resolution divisions within the Revenue Cycle Department.
• Tracks departmental processes and reports to ensure KPI benchmarks are met and resolves variances.
• Oversees policies and procedures, onboarding, and competency-based education.
• Leads a diverse staff, conducts hiring, performance reviews, mentorship, and discipline when needed.
• Oversees charge description master maintenance, system integrity, and revenue capture; coordinates Enterprise Change Control.

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?

Entity: Clinical Practices of University of Pennsylvania

Department: Medicine Revenue Cycle

Location: Penn Presbyterian Medical Center- 51 N 39th St

Hours: Per Departmental Needs

Summary

This position is responsible for all Revenue Cycle front end billing issues, including charge interface, charge description, master dictionaries, billing exceptions and edits, and all contracted payment accounts. 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 and 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 the department. 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 Revenue Integrity and Account Resolution divisions within the 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 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 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.

Credentials

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

Education or Equivalent Experience

• Bachelor's degree in Healthcare, Finance, Management, or related AND 5+ years Hospital or Practice Revenue Cycle Setting, including previous supervisory/management experience (Required).
• OR
• Associate's Degree in Healthcare, Finance, Management, or related AND 7+ years Hospital or Practice Revenue Cycle Setting including previous supervisory/management experience (Required).
• OR
• HSD/GED AND 10+ years Hospital or Practice Revenue Cycle Setting, including previous supervisory/management experience (Required).

Skills & Abilities

• Strong expertise in hospital-based revenue cycle cycle operations and industry best practices including registration, billing, collections & bad debt, payment processing, denial management and accounts receivable finance operations, fee schedule, documentation & coding, charge description master and charge capture.
• Ability to create a positive, engaging, and motivating work environment that appeals to all types of employees, and align the goals of the unit to people’s motivators. Inspires and fosters team commitment, spirit, pride, and trust. Facilitates cooperation and motivates team members to accomplish group goals.
• Ability to oversee multiple levels of staff (managing managers, supervisors, front line staff, etc), appropriately delegate, and direct the efforts of others.
• Develops the ability of others to perform and contribute to the organization by providing ongoing feedback and by providing opportunities to learn through formal and informal methods, including mentoring and development of other leaders in these areas.
• Superior technical aptitude to learn, navigate, and effectively teach others EMR, Billing, and other applicable software platforms. Familiarity with revenue cycle information systems and how they can be leveraged to systemize good process. Specialized training or demonstrated successful experience in IS Project Management and Workflow creation.
• Ability to perform tasks in Microsoft Office (Excel, Power Point, Word) as an expert user, with ability to analyze large, complex data sets quickly and effectively.
• Understanding of medical terminology, pathophysiology, and pharmacology as it applies to disease process and the justification for medical imaging, therapeutic, and surgical interventions.
• Knowledge and understanding of front to back-end revenue cycle business processes, and their impact on the patient care experience. Develops new insights into situations; questions conventional approaches; encourages new ideas and innovations; designs and implements new or cutting edge programs/processes.
• Ability to manage difficult situations with tact and diplomacy, and defuses high-tension situations effectively. Encourages creative tension and differences of opinions. Anticipates and takes steps to prevent counter-productive confrontations. Manages and resolves conflicts and disagreements in a constructive manner.
• Strong communication skills with all levels of staff and personnel, effectively align and negotiates interests between multiple, diverse stakeholders. Makes clear and convincing oral and written presentations. Listens effectively; clarifies information as needed. Asks thought provoking questions to identify root cause and underlying factors of situations, adjusts communication style as needed for audience.
• Experience in managing complex, large-scale projects and/or multiple departments and establishing detailed work plans and setting priorities. Proven leadership skills in a matrix management environment that includes influencing, efficiency, collaboration, candor, and openness with a focus on results orientation.
• Ability to remain agile and effective, dealing effectively with pressure; remains optimistic and persistent, even under adversity. Recovers quickly from setbacks.
• Understands and keeps up-to-date on local, national, and international policies and trends that affect the organization and shape stakeholders' views; is aware of the department’s impact on the external UPHS environment.
• Makes well-informed, effective, and timely decisions, even when data are limited or solutions produce unpleasant consequences; perceives the impact and implications of decisions. Takes measured, calculated risks to accomplish organizational objectives.
• Maintains a high level of self-awareness. Assesses and recognizes own strengths and weaknesses; pursues continual self-development.
• Experienced EPIC system user, comfortable with both operational functions as well as reporting mechanisms. Familiarity with Epic structure, maintenance of dictionaries, and other advanced functions (Preferred).

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.