Manager PB Coding Denials Integrity - Medical Specialties

Department:

13245 Enterprise Revenue Cycle - Integrity Operations: Professional Coding Denials Status:

Full time Benefits Eligible:

Yes Hou rs Per Week:

40 Schedule Details/Additional Information:

Will support:

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PB Med Specialties: Laboratory, Pathology, Behavioral Health, Peds development, Allergy and Immunology, Dermatology, Gastro, Hepatology, Infectious Disease, Endocrinology, Nephrology, Rheumatology, Pulmonology, Sleep, VH, MFM, OB/GYN, OB GYN/Repro Endo, and UROGYN

Schedule:

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Monday - Friday 1st shift 40 hours a week.

Certification required:

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Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA).

- Dual Certification preferred.

Remote opportunity:

Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY
Pay Range:
$51.05 - $76.60
Manager PB Coding Denials Integrity - Medical Specialties / Manager Med Revenue Cycle Major Responsibilities:

- Operational Leadership: Lead and manage daily operations within the assigned function area, ensuring alignment with divisional and enterprise-wide goals.

- Operational Efficiency: Evaluate processes to improve efficiency, enhance productivity, and support standardized best practices across the Mid-Revenue Cycle.

- Regulatory Compliance & Confidentiality: 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.

- Performance Monitoring & Reporting: Utilize key performance indicators (KPIs) to measure effectiveness, track trends, and implement data-driven strategies for improvement.

- Technology Utilization: Leverage healthcare technology and analytics tools to enhance efficiency, support decision-making, and drive innovation in Mid-Revenue Cycle processes.

- Collaboration & Stakeholder Engagement: 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.

- Team Leadership & Development: 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.

- Strategic Initiatives & Execution: Lead initiatives to improve operational effectiveness, oversee timelines, and drive system enhancements.

Licensure, Registration, and/or Certification Required:
- Relevant industry certification from an approved accrediting body.

Education Required:
- Bachelor’s degree in health information management,Healthcare Administration, or a related field, or equivalent experience.

Experience Required:
- ​​Minimum 8 years of experience in mid-revenue cycle operations, coding, HIM, or healthcare technology, including 2+ years of leadership experience in a large integrated healthcare system.

Knowledge, Skills & Abilities Required:

- Mid-Revenue Cycle Expertise: 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).

- Financial & Data Analysis: Ability to organize, compile and analyze data from various sources in order to detect patterns, and identify areas for improvement.

- Tec