Department:
Status:
Benefits Eligible:
Hours Per Week:
Schedule Details/Additional Information:
na
Pay Range
$51.05 - $76.60Major Responsibilities:
Establishes and maintains formal processes and internal controls to ensure new charges accurately reflect the service provided and are compliant with federal and state regulation and payer contracts
Provides education and consultation for the systems clinical and finance team members for charge capture inquiries.
Monitors reports and work queues to identify patterns of charge variance to identify opportunities for improved revenue performance.
Sets direction and performance goals for Revenue Integrity team to ensure timely and accurate charge selection reflective of patient services rendered.
Develops and utilizes key data indicators to monitor processes in order to streamline workflow, design operations and improve quality, service and performance.
Responsible for researching and resolving regulatory and contract compliance issues with the compliance team and system leaders. Proactively reviews federal and state regulations and payer contracts/policies for necessary changes related to coding and billing practices
Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives.
Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations, and overall employee morale
Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business.
Licensure, Registration, and/or Certification Required:
None Required.
Education Required:
Bachelor's Degree in health care administration, Finance, HIM, Nursing or other related field.
Experience Required:
Typically requires 7 years of experience in hospital operations management: clinical, revenue cycle, payer contracting, financial.
Knowledge, Skills & Abilities Required:
Strong knowledge of hospital revenue cycle operations and systems and process improvement methods.
Demonstrated leadership skills and ability to manage multiple priorities in a dynamic work environment.
Strong analytical, decision-making and prioritization skills.
Ability to work well within a team atmosphere while recognizing and meeting the individualized needs of customers and internal partners.
Excellent interpersonal, negotiation, diplomatic, problem-solving skills with the ability to successfully and positively interact with individuals across all hierarchical levels within the organization, as well as outside partners (e.g., insurance/payer representatives).
Knowledge of hospital reimbursement, hospital managed care contracts; government payer reimbursement regulations; knowledge of CMS billing regulations and outpatient reimbursement systems.
Strong knowledge of Hospital coding: ICD-10, CPT, HCPCS, Revenue Codes, DRGs; experience with hospital charge description masters (CDMs).
Demonstrated experience using Hospital clinical systems and Microsoft applications.
Physical Requirements and Working Conditions:
This position requires travel, therefore, will be exposed to weather and road conditions.
Operates all equipment necessary to perform the job.
Exposed to a normal office environment.
DISCLAIMER
All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.
This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position. Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Compensation
- Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
- Premium pay such as shift, on call, and more based on a teammate's job
- Incentive pay for select positions
- Opportunity for annual increases based on performance
Benefits and more
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
Top Skills
What We Do
Advocate Aurora Health is the 11th largest not-for-profit, integrated health system in the United States. As a leading employer in the Midwest, Advocate Aurora Health employs more than 75,000 individuals including more than 22,000 nurses. Advocate Aurora is engaged in hundreds of clinical trials and research studies, and is nationally recognized for its expertise in cardiology, neurosciences, oncology and pediatrics. The organization contributed nearly $2.2 billion in charitable care and services to its communities in 2019.
