Purpose:
Provide strategic direction, guidance, and accountability for the management of key UPMC Corporate Revenue Cycle business processes. Accountable for recurring & ad-hoc Financial Reporting requirements necessary to support financial statements, budgeting, and patient accounting financial metrics. Ensures effective and efficient operational processes for assigned areas, and for developing and implementing process change that drive improved financial results.
This position will be focused on the analytics around physician revenue cycle.
Responsibilities:
- Maintain current knowledge of Federal and State regulations related to third party billing, coding, reimbursement and collections. Perform duties and job responsibilities in a fashion which align with the service management philosophy of the UPMC Revenue Cycle including the demonstration of the basics of service excellence towards patients, visitors, staff, peers, and other UPMC departments.
- Adhere to all intra and extra organizational compliance and HIPAA regulations. Ensure compliance with state and federal regulations and/or guidelines and assure reimbursement for services provided. Ensure compliance with Sarbanes Oxley Requirements.
- Oversee and direct ongoing financial analysis of third party billing and payment trends, working with payers and UPMC operations as necessary to investigate and resolve issues. Directs operational reporting resources to ensure that key performance indicators and trending metrics are appropriately monitored.
- Provide strategic input and Revenue Cycle representation as member of the Enterprise Data Analytics design and deployment team.
- Ensure that recurring Revenue Cycle meetings with Finance leadership to review revenue cycle reports, updates, issues, and action plans are adding value and supporting organizational goals.
- Provide leadership and strategic direction for revenue cycle financial reporting for all UPMC Physician Division Business units, encompassing the development of standard and ad-hoc financial reports to support the General Accounting close-process, as well as financial trending reports for performance and budget management.
- Identify, recruit and develop high-performing Revenue Cycle management team members. Develop & sustain an organizational culture that encourages productivity, loyalty, job satisfaction and continuous process improvement.
- Develop, communicate, implement and evaluate goals and objectives for Revenue Cycle Department. Provide the proper supervision, environment and reporting structure to assure productivity, performance and well- being of Revenue Cycle employees.
- Bachelor's degree in finance, accounting or related business field required.
- Minimum of seven years of related work experience required.
- Minimum of two years managerial or supervisory experience required.
- CPA/MBA or equivalent advance degree preferred.
- Able to establish appropriate procedures to ensure the proper day-to-day management of large scale revenue cycle operations.
- Thorough and comprehensive knowledge of healthcare and Revenue Cycle operations policies and procedures necessary to develop programs, coordinate activities, and motivate and instruct others.
- Possess in-depth knowledge of medical terminology, third party payer eligibility requirements, registration, scheduling, charge processing, third party payer billing requirements and reimbursement practices, regulatory guidelines, and in-depth knowledge of coding as it relates to physician billing.
- Possess proficient knowledge of computer software consisting, but not limited to Microsoft Office and extensive experience with healthcare patient accounting systems (EPIC knowledge/experience preferred). Demonstrate the ability to make effective decisions, both independently and cooperatively as appropriate.
- Demonstrate sufficient quantitative skills to use statistics to help decision-making, to perform cost-benefit analysis, and make reasonable future projections.
- Able to function in a high-pressure environment with very little direct supervision.
- Able to motivate a large staff faced with consistent and repeated deadlines to work efficiently in a team environment.
- Dependable, highly professional in manner and able to prioritize and delegate as appropriate a demanding workload.
- Excellent and proven strong interpersonal and communication skills, both written and oral, and the ability to effectively problem solve. Interpersonal abilities necessary to effectively deal with all levels of UPMC Finance Division personnel, as well as legal representatives, third party payers, patients, etc.
Licensure, Certifications, and Clearances:
- Act 34
*Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state.
UPMC is an Equal Opportunity Employer/Disability/Veteran