About the UnitIn the Department of Pediatrics at the University of Chicago, we strive to provide the highest level of complex care for children from diagnosis and treatment to conducting research to find promising new therapies with a focus on teaching. We are committed to advancing the frontiers of knowledge, and the education and training of future clinical pediatricians, subspecialists, educators, clinical investigators and physician-scientists. Professional and investigative aspects of medicine are readily combined and the attributes of academic life are easily recognized in the Department of Pediatrics. Our faculty and staff value the designation 'teacher of teachers' and appreciate the importance of research training, individual creativity and high quality comprehensive clinical care and service. The Department of Pediatrics is a dynamic, stimulating place to work, and because we are focused on growth and improved excellence, our staff have particularly challenging and rewarding roles. We seek to hire an experienced Clinical Revenue Manager to oversee the revenue cycle activities for the department with the goal of maximizing charge capture and reimbursement in a cost-effective manner that is in compliance with federal, state and payer-specific billing requirements. Qualified candidates must possess a deep understanding of the charge capture and coding processes. The Clinical Revenue Manager will provide ongoing audits and training to managers and providers by specifically focusing on charge capture and coding activities. The ideal candidate will be a certified coder with previous charge capture experience.
Job FamilyFinancial ManagementResponsible for accounting, budgets and financial controls, payroll, purchasing, risk management, and treasury for the University. Sets financial strategy that impacts University functions such as grant awards, clinical research, and investments of capital.
Career Track and Job LevelClinical RevenueDevelops, enhances, and effectively oversees revenue cycle operations, including activities related to charging, billing, and collecting. Expands and coordinates the Clinically Integrated Network. Assists department managerial and executive staff in the management of successful billing and compliance activities.P3: Requires in-depth knowledge and experience. Uses best practices and knowledge of internal or external University issues to improve products or services. Solves complex problems; takes a new perspective using existing solutions. Works independently, receives minimal guidance. Acts as a resource for colleagues with less experience.
Role ImpactIndividual Contributor
ResponsibilitiesThe job uses best practices and knowledge related to revenue cycle operations, including activities related to charging, billing, and collecting. Coordinates the management of successful billing and compliance activities with department managerial and executive staff.1) Has a deep understanding in the areas of chart documentation and maintaining requirements within the department. Ensures all processes involved in accurately posting professional fees., 2) Has a deep understanding of coding procedures, workflow issues, billing infrastructure, and performance of Clinical Revenue staff. Informs department administrators, physicians, and Coder/Abstractors of regulatory changes., 3) Guides departmental compliance efforts by participating in training sessions, performing audits, and promoting an understanding of procedures, policies, and expectations., 4) Performs other related work as needed.
1) Supervise the activities of the professional billing staff by recruiting and training, monitoring workloads, setting priorities for completion of tasks, and ensuring quality and timely output
2) Oversee and provide strategic direction of the Department’s professional fee billing efforts to ensure regulatory compliance and appropriate charging and collection activities. This consists of, but should not be limited to: working with faculty and staff to ensure proper medical record documentation for services provided and proper coding of services billed, developing and maintaining billing database for use by staff, and improving processes as needed
3) Represent the interests of the clinical department to colleagues in the Biological Sciences Division and University of Chicago Medicine. Act as a departmental liaison with University of Chicago Physicians Group (UCPG) to facilitate the flow of data into the UCPG system. Serve as a liaison with UC Medicine Medical Records, Hospital Administration, Finance, Admitting, Quality Assurance, Medical Center Information Systems, and the Medical Staff Office
4) Keep senior departmental administrators and faculty apprised of regulatory changes and their impact. Coordinate long-range planning of implementation of new procedures as a result of these changes
5) May participate in facilitating seminars and workshops on coding techniques, medical records documentation, and regulatory compliance to staff and providers, as needed
6) Develop departmental policies relating to billing activities and practices
7) Develop and prepare/utilize reports to track financial and operational performance of the revenue cycle process
8) Research/analyze data to resolve charge capture and reimbursement issues, identify and select alternatives to address outstanding issues and implement solutions for improvement, Work with department leadership, finance, physicians, and administrators to educate and train providers and staff about coding and other outstanding revenue cycle issues
1) Thorough working knowledge of federal and state regulations regarding reimbursement
2) Demonstrated ability in financial analysis and modeling
3) Thorough working knowledge of medical terminology validated by testing or certification
4) Knowledge of third party payer rules, procedures, policies, and industry trends in all areas of billing and collection
5) Familiarity with electronic billing and medical records systems, specifically Epic
6) High levels of decision-making skill, accountability, and creativity
7) PC experience that includes knowledge of spreadsheet, word processing, presentation, and database software
8) Communicate technical information to departmental faculty and staff
9) Excellent ability to read, understand and interpret, analyse and apply complex regulatory requirements
10) Work efficiently under pressure
11) Apply appropriate supervisory, management, and leadership techniques
12) Work independently and take initiative
13) Deal effectively with change, and be a change agent
14) Deal effectively with difficult situations
15) Set priorities and use food judgement for self and staff
16) Work with changing deadlines and shifting priorities
Education, Experience, and CertificationsMinimum requirements include a college or university degree in related field.Minimum requirements include knowledge and skills developed through 5-7 years of work experience in a related job discipline.
1) Bachelor’s degree in business, economics, or related field
Licenses and Certifications
1) Certification through a nationally accredited body (e.g., AAPC, AHIMA) strongly preferred
1) Five (5) years working in a healthcare (professional) billing, health insurance, Coding or equivalent operations work environment
2) Two (2) years of previous supervisory experience
3) Previous coding and charge capture experience strongly preferred, as well as thorough working knowledge of ICD-10CM and CPT-4 coding systems.
4) Previous experience with charge capture management and gross revenue management
5) Epic revenue cycle and/or clinical applications
6) Prior experience in a hospital finance setting (i.e. reimbursement, charge master, patient financial services, hospital operations, etc.).
2) Cover Letter
NOTE: When applying, all required documents MUST be uploaded under the Resume/CV section of the application.