Yale University offers exciting opportunities for achievement and growth in New Haven, Connecticut. Conveniently located between Boston and New York, New Haven is the creative capital of Connecticut with cultural resources that include three major museums, a critically-acclaimed repertory theater, state-of-the-art concert hall, and world-renowned schools of Architecture, Art, Drama, and Music.
This position oversees the clinical practices and labs for the Department of Genetics. Addresses all MD/faculty concerns regarding compliance and documentation requirements. Monitors and modifies existing billing and compliance requirements relating to regulatory and payer specific needs. Reviews all Payer Contracts working collaboratively with Yale Medicine (YM) Contracting Officer to negotiate and maximize department revenue. Works closely with Reimbursement staff to identify denials which can be addressed within contracting and appeal processing. Utilizing Epic and WEBI, generates reports and analyzes billing to ensure charges are pushed correctly and meet timely filing deadlines. Prepares and analyzes reports to identify outstanding encounters and documentation errors, as well as billing and collections levels/issues for the clinics. Communicates these issues to the MD/faculty and clinical staff for resolution. Monitors and enforces compliance with YM policies and procedures, practice standards, HIPAA, and compliance training. Assists and supports the YM Compliance Department with all internal and external audits relating to both clinical documentation and billing/coding. Supports and assists the reimbursement staff with any issues regarding appeals, denials, or revenue reduction due to EPIC, carrier, or YM related matters.
Works collaboratively with Reimbursement Specialists and YM Contracting Officer to identify and communicate impact of department reimbursement regarding modification of carrier policies and procedures. Reviews department fee schedules (YM, International, clinical trial, etc.) on an annual basis. Responsible for timely credentialing/re-credentialing requirements of all clinical practice providers. Runs weekly rejection reports to optimize collections. Provide guidance and assistance in prior authorization process pertaining to genetic testing. Researches new test requests to determine reimbursement requirements and communicates information as needed. Ensures compliance with established department procedures. Attend meetings related to the clinical practice and maintains detailed reports. Participates in special projects as required. Supervises, hires, trains and provides support and expertise to administrative and billing staff and ensures that billing and coding compliance meets the guidelines dictated by the University Compliance Office and ensures clinics run smoothly.
Required Education and Experience: Bachelor’s Degree and four years of related work experience or an equivalent combination of education and experience. AAPC (CPC) certification
• Excellent managerial and organizational skills.
• Experience with ICD10 and CPT Coding.
• Experience with EPIC or similar EMR and Microsoft Office. Intermediate Excel skills.
• Exceptional ability to proactively manage and anticipate change. Ability to work both independently and as part of a team.
• Excellent communication skills both oral and written. Excellent interpersonal skills. Excellent attention to detail.
• Preferred Education and Experience: Previous managerial experience preferred.
Application: For more information and immediate consideration, please apply online at http://bit.ly/YaleCareers-59808BR. Please be sure to reference this website when applying for this position.
We invite you to discover the excitement, diversity, rewards and excellence of a career at Yale University. One of the country's great workplaces, Yale University offers exciting opportunities for meaningful accomplishment and true growth. Our benefits package is among the best anywhere, with a wide variety of insurance choices, liberal paid time off, fantastic family and educational benefits, a variety of retirement benefits, extensive recreational facilities, and much more.
Yale University considers applicants for employment without regard to, and does not discriminate on the basis of an individual’s sex, race, color, religion, age, disability, status as a veteran, or national or ethnic origin; nor does Yale discriminate on the basis of sexual orientation or gender identity or expression.