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Vanderbilt University Medical Center Senior Revenue Cycle Advisor - 100% REMOTE in Helena, Montana

Senior Revenue Cycle Advisor - 100% REMOTE - 2213615

Job : Medical Coding and Billing

Primary Location : Work from Home

Organization : Revenue Management 108414

Shift: : First Shift

Description

Sr. Revenue Cycle Advisor - 100% Remote

JOB SUMMARY:

Serve as a liaison between clinical operations and the Revenue Cycle Department. Collaborate closely with Coding, Health IT, and other Revenue Cycle and Finance departments to optimize workflows. Evaluates revenue cycle performance and ensure appropriate reimbursement of professional services.

KEY RESPONSIBILITIES:

  • Generalist rev cycle experience (patient registration, billing, collections, provider enrollment, contract management, etc.) needed to perform daily tasks

  • Project management skills and leadership skills required to facilitate problem-solving collaboratively with multiple stakeholders

  • Engage in continuous process improvement initiatives to ensure a high-quality and cost-efficient billing and collection operation

  • Evaluate professional billing KPI Indicators utilizing Tableau, Business Objects, and Epic reports independently.

  • Report KPI Metrics to stakeholders (physicians and administrators) on a regularly scheduled cadence

  • Designs, plans, and implements billing procedures and systems for new services to ensure effective billing operations

  • First point of contact for clinical operations, department leaders, and providers regarding billing and coding questions

  • Facilitates necessary training and oversight to ensure competency concerning billing compliance and regulatory matters

  • Facilitates the coordination with the Office of Legal Affairs, Compliance, Charge Integrity, Charge Master, VMG Coding, HIM, providers, and department leaders when new service lines are being considered

  • Connect clinic operations, providers, and support staff with the appropriate IT team when they encounter workflow issues the Senior Revenue Cycle Advisor staff cannot resolve

  • Create Pegasus tickets for new subdivisions, bill areas, and provider mapping

  • Review Medical Staff Actions, Delegated Credentialing for Enrollment (DCE) reports, and credit work queues to ensure providers are mapped appropriately and timely

  • Create and/or approve all provider Additional Location Forms for Payer Enrollment e-Files

  • Develop job aids

  • Make connections for Hospital Billing Senior Revenue Cycle Advisors to our clinical operation leaders when workflows, charge triggers, and EAP worksheets are needed

  • Participate in Quarterly CPT Change meetings with our Hospital Billing Senior Revenue Cycle Advisor counterparts to determine if new codes will be used in the clinic or inpatient setting

  • Present change control tickets when enhancements are needed or break-fix assistance is required

  • Identify and resolve systemic issues

  • Manages performance of billing function with respect to established operating standards

  • Manage multiple accounts, charge review, charge routers, and credit work queues to ensure responsible parties resolve issues timely

  • Participate in claims testing when new clinics, procedures, or facilities ramp up

  • Stakeholder in all system implementations related to the revenue cycle. Designs, plans, and implements billing procedures and systems for new services to ensure effective billing operations.

  • Research patient billing complaints received from patient billing, clinics, departments, and providers

  • Facilitates necessary training and oversight to ensure competency concerning billing compliance and regulatory matters.

  • The responsibilities listed are a general overview of the position, and additional duties may be assigned.

TECHNICAL CAPABILITIES:

REVENUE CYCLE (ADVANCED) - Knowledge of the financial process to track patient care from registration and scheduling to the final payment of a balance.

PROBLEM SOLVING (ADVANCED) - Uses critical thinking and process improvement i.e., coaches and mentors development of problem statement, describes current state, identifies root causes, creates future state, coaches and mentors development of solutions and action plans with a sustainability plan. Applies appropriate tools to address issues.

PROCESS IMPROVEMENT (ADVANCED) - Identifies, analyzes, and improves upon existing business processes for optimization and to meet quality standards.

CORE ACCOUNTABILITIES:

  • Organizational Impact: Independently delivers on objectives with understanding of how they impact the results of own area/team and other related teams.

  • Problem Solving/ Complexity of work: Utilizes multiple sources of data to analyze and resolve complex problems; may take a new perspective on existing solution.

  • Breadth of Knowledge: Has advanced knowledge within a professional area and basic knowledge across related areas.

  • Team Interaction: Acts as a go-to resource for colleagues with less experience; may lead small project teams.

CORE CAPABILITIES:

SUPPORTING COLLEAGUES (P2):

  • Develops Self and Others: Invests time, energy and enthusiasm in developing self/others to help improve performance and gain knowledge in new areas.

  • Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships.

  • Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences.

DELIVERING EXCELLENT SERVICES (P2):

  • Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.

  • Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions.

  • Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness.

ENSURING HIGH QUALITY (P2):

  • Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.

  • Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them.

  • Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring.

MANAGING RESOURCES EFFECTIVELY (P2):

  • Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure.

  • Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area.

  • Makes data-driven decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities.

FOSTERING INNOVATION (P2):

  • Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches.

  • Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges.

  • Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.

JOB QUALIFICATIONS

  • Required:

  • Bachelor's Degree and five years of experience in revenue cycle

  • Proficient in Microsoft Office (Work, Excel, PowerPoint, Visio)

  • Preferred:

  • Experience in Behavioral Health revenue cycle operations

Basic Qualifications

Bachelor's Degree (or equivalent experience) and 4 years relevant experience

Licensure, Certification, and/or Registration (LCR):

  • Physical Requirements/Strengths needed & Physical Demands:

  • Sedentary category requiring exertion up to 10 lbs. of force occasionally and uses negligible amounts of force to move objects. Sedentary work involves sitting most of the time. Movement

  • Occasional: Standing: Remaining on one's feet without moving.

  • Occasional: Walking: Moving about on foot.

  • Occasional: Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another

  • Occasional: Carrying under 35 lbs: Transporting an object holding in hands, arms or shoulders, with help of coworkers or assistive device.

  • Occasional: Push/Pull: Exerting force to move objects away from or toward.

  • Occasional: Bending/Stooping: Trunk bending downward and forward by bending spine at waist requiring full use of lower extremities and back muscles

  • Occasional: Reaching above shoulders: Extending arms in any direction above shoulders.

  • Occasional: Reaching below shoulders: Extending arms in any direction below shoulders.

  • Occasional: Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.

  • Occasional: Bimanual Dexterity: Requiring the use of both hands.

  • Frequent: Sitting: Remaining in seated position

  • Frequent: Fingering: Picking, pinching, gripping, working primarily with fingers requiring fine manipulation. Sensory

  • Continuous: Communication: Expressing or exchanging written/verbal/electronic information.

  • Continuous: Auditory: Perceiving the variances of sounds, tones and pitches and able to focus on single source of auditory information

  • Continuous: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision. Environmental Conditions

Req ID: 2213615

Vanderbilt University Medical Center is committed to principles of equal opportunity and affirmative action.

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