Senior Manager, Outpatient Coding, Revenue Cycle

UPMC Corporate Revenue Cycle is seeking an experienced Senior Manager to lead our Coding Department. This is a remote position that may require on-site work as needed. We are looking for someone who has strong experience with coding and charging for outpatient facilities.

As the Senior Manager you will be responsible for the day to day management and operations of the Outpatient Coding department for hospital outpatient/technical coding and/or profee coding under the control of the centralized profee coding department.all (ie. (i.e. University of Pittsburgh (UPP) departments/Physicians, all Community Medicine Practices/Physicians and any other entity which the central coding division provides coding services). Engagement with Department Administrators, Department Chairs and other senior Physicians, Hospital CEOs/CFOs and Sr. Physician Division Management on all revenue cycle coding related issues. Ensures timely coding and charge processing for all aspects of the Revenue Cycle operations within the Outpatient Coding Division.

Responsibilities:

• Assist Director Outpatient Coding/Revenue Cycle Division with special projects as needed/requested. Ensure timeliness and accuracy of the processes performed to result in patient satisfaction, optimal collections/reimbursement and efficient cash flow.
• Maintain current knowledge of Federal and State regulations related to third-party billing, coding, reimbursement and collections. Develop and maintain relationships with payors, practices, law offices and other outside professional organizations.
• Responsible for routine revenue cycle coding-related meetings with all UPMC department Administrators, UPMC Department Chairs, Practice Administrators and Hospital CFO’s when appropriate, and other Physicians to review all revenue cycle coding-related reports, updates, issues, and follow-up/plan of action. Create and maintain standard revenue cycle coding reports, needed ad hoc reports, and an issue matrix, which will be used to document and track progress on all issues for all departments
• Establish quarterly and annual goals and objectives for the revenue cycle coding department.
• Responsible for directly intervening and addressing all revenue cycle issues that are escalated to Sr. management, Department Chairs, etc.
• Work closely with Senior Physician Division management to develop/implement plan of action for all outstanding revenue cycle coding-related issues. Ensure appropriate follow-up and resolution occur.
• Responsible for ensuring pro-active and reactive Revenue Cycle analysis for all applicable UPMC outpatient departments, and physician practices to determine trends as it relates to CPT, Third Party Payors, Outstanding/Aging A/R, Denial issues etc.. Responsible for reviewing all findings with the UPMC Physician Division Senior management, department administrators and Department Chairs/Physicians and developing, implementing and reviewing resolution/plan of action for outstanding outcomes of Revenue Cycle analysis, assign responsibilities and ensuring progress/ plan of action is attained in a timely manner.
• Perform ongoing financial analysis of third party billing/coding and payment trends. Work with payors (in conjunction with other senior management) as necessary to investigate and resolve issues.
• Represent the Central Coding (Outpatient) Revenue Cycle Division in meetings both internally and externally.
• Maintain a good relationship with administration and clinical leadership.
• Involves management/oversight of outpatient coding functions within the Revenue Cycle Coding Division, while working closely with Sr. Physician division management, Department Administrators, Department Chairs (and other appropriate senior Physicians), and Sr. Hospital Management to ensure all revenue cycle-related goals are met, A/R is appropriately managed, and financial progress is attained.
• Responsible for developing and implementing revenue cycle coding procedures/enhancements to all UPP Departments and CMI practices and hospital outpatient departments. Must ensure all protocols are being followed/met to ensure optimal revenue cycle/financial performance related to coding.
• Performs duties and job responsibilities in a fashion which coincides with the service management philosophy of the Revenue Cycle Division, including the demonstration of the basics of service excellence towards patients, visitors, staff, peers, physicians, practice staff and other departments within the UPMC Health System.
• Provide quality assurance programs for the monitoring of outpatient coding completed internally as well as externally (decentralized coding areas).