Manager Payment Integrity Professional Billing

Job Qualifications

People :

• Responsible for the direction and coordination of all payment integrity operations related to the processing and adjudication of professional claims to insurance.
• Manages all essential payment integrity team functions. Effectively leads and develops a team including training.
• Ensures all payment integrity team staff are current in competencies assessments licensure certifications and other annual training.
• Ensures work environment complies with regulatory licensure compliance and accreditation requirements by monitoring the work setting on an ongoing basis to identify deficiencies risk and opportunities for improvement.
• Participates in and completes all required employee training including recurring and ad-hoc education sessions.
• Enforces and monitors corrective action plans.

Quality :

for improvement. Ensures productivity goals metric benchmarks and quality standards are consistently met by all team members.

Service :

Financial :

Growth :

Education

Associates Degree Business Administration Finance or other healthcare related degree Required

Or

Bachelors Degree Business Administration Finance or other healthcare related degree Preferred

Or

Masters Degree Preferred

Experience

8 Years Experience in payment integrity for professional billing for a provider group. Extensive knowledge in reporting and analytics resolving payer issues ongoing tracking and trending attending JOCs(Joint Operating Committee) Required

5 Years Management Experience Required

Epic Experience a Plus

Licenses and Certifications

Other Dual Hospital and Professional Coding Certification(s) (CPC CPC-H CCS CCSP). Upon Hire Preferred

Skills

Possess a strong work ethic and a high level of professionalism.

Demonstrates good understanding of health insurance billing follow-up credits regulations and payer requirements.

Proficient computer and EMR skills including but not limited to Microsoft Office suite applications such as Word and Excel.

Demonstrated business and analytic / financial skills.

Strong communication and organizational skills.

Proven experience in a billing environment.

Strong people management and development skills.

Ability to shape communications to the needs of the audience.

Knowledgeable of HIPAA state and federal regulations governing confidentiality release of information and record retention.

Familiar with Electronic Medical Record (EMR) functionality document imaging and workflow. Epic CareConnect EMR experience and certifications are a plus.

Must be a dependable self-starter and deadline driven. Must have the ability to work well independently and in a team setting to meet organizational goals.

Must demonstrate solid understanding of key revenue cycle workflows technical system and metric goals.

Why Texas Health

At Texas Health Resources our mission is to improve the health of the people in the communities we serve.

As part of the Texas Health family and its 28000 employees were one of the largest employers in the Dallas Fort Worth area. Our career growth and professional development opportunities are top-notch and our benefits are equally outstanding. Come be a part of our exceptional team as we improve the health of the people in our communities every day. You belong here.

Learn more about our culture benefits and recent awards.

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Manager Payment Integrity Professional

Are you looking for a rewarding career with family-friendly hours and top-notch benefitsWere looking for qualifiedcandidateslike you to join our Texas Health family.

Position Summary

Under general direction of the PBO Revenue Integrity Director the PBO Payment Integrity Manager is responsible for overseeing insurance payment activities to ensure accuracy proper escalation and effective resolution. Consistent fiscal performance and achievement of specific departmental standards and goals. The Manager oversees direct staff to ensure stated goals are met through the following processes : vetting reported issues proactive and reactive reporting to capture impact payer escalations attending JOCs (Joint Operating Committee) monthly report outs for executives on progress and outstanding issues. The manager is also responsible for monitoring and improving all revenue cycle metrics and measures including but not limited to the following : AR days aged AR cash collections denials avoidable write-offs staff productivity and work quality. All responsibilities are performed in accordance with established organizational policies procedures and compliance and quality standards.

Required Experience :

Manager

Key Skills

Revenue Cycle Management,Athenahealth,ICD-10,Management Experience,Medical Coding,ICD-9,Medical Billing,Budget management,CPT Coding,Leadership Experience,Medicare,Supervising Experience

Employment Type : Full-Time

Experience : years

Vacancy : 1