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Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Entity - Corporate Services

Department - Central Fee Abstract Corp

Location - 2 Bala Plaza

Hours - M-F, 8 hr days, hybrid

Summary:

+ The Professional Fee Coding Manager, Revenue Cycle is responsible for leading the oversight of the timely and accurate professional fee coding across all entities to ensure timely and optimal billing and reimbursement to support established Health Information Management and Revenue Cycle goals and objectives. The Manager stays abreast of the professional fee coding industry guidelines and regulatory changes, health system coding trends and ensure the necessary revenue cycle activities are performed by the CFA team. The Manager also assists with the routine development of CFA department coordinator and analyst staff, the hiring of qualified candidates, as well as develops, maintains and implements revenue cycle activities that support the goals of the organization. The Manager ensures all CFA direct reports are regularly educated on issues related to coding, compliance, and ICD-10 and CPT principles. Supports the oversight of any coding quality initiatives that may be necessary as a result of internal and/or external audit activities as well as mitigating any potential risk areas that may be identified. Responsibilities also include monitoring CFA team production and accuracy, reporting on that production and accuracy, as well as partnering with colleague Coding Managers in overseeing the education, audit and coding operational functions to include the creation of remediation plans as necessary. This includes both onsite Penn Medicine coders and auditors as well as any coding support vendors.

Responsibilities:

Responsible for CFA Revenue Cycle Management for all UPHS hospitals and physician practice groups within the CFA scope.

Direct oversight of Professional Fee Coding Data Integrity Coordinator; Analyst, Data and Continuous Improvement; and Provider Liaison, Clinical Documentation Improvement.

Responsible for the Inpatient and Outpatient Charge Lag and CFB.

Communicate barriers to accomplishing revenue cycle metrics to senior leadership in a timely fashion. Collaborates with the HIM and CFA management as well as organizational leadership in developing coding revenue cycle metrics and in strategic planning.

Responsible for PennChart work queue- monitoring of IP and OP charts uncoded or edited, CFA tickets for denials, edits or questions as well as collaboration on department Claim Edit work queues.

Monitors the flow of uncoded records across departments to ensure that all records are coded or correctly placed on the appropriate coding hold for timely processing. Coordinates with the Coding Coordinators, Coding Managers and Operations Managers to assist with obtaining outstanding items needed to complete coding.

Alerts the Director of any consistent or problematic obstacles to timely documentation and coding that require intervention at an administrative level.

Provides oversight and management of the IP and OP DNFB and department charge lag reports across all applicable entities.

Communicates deficiencies and gaps that need to be addressed with the Coding Managers.

Communicates with coding management, physicians, and other hospital staff regarding clinical documentation and reimbursement issues impacting the revenue cycle.

Coordinates with the Coding Managers to provide department revenue cycle leaders with necessary coding information as needed to facilitate claim submission.

Identifies and monitors the high dollar and high length of stay cases that remain outstanding for timely completion.

Summarizes and reports revenue cycle standings and dashboard metrics related to the revenue cycle on a monthly and quarterly basis.

Oversees communication with CRM to assist in appropriate account type resolution based on payer, coding, contracts, etc.

Identifies and communicates documentation issues and concerns impacting the revenue cycle regarding coding and other abstracting data elements to management as identified.

Assists CPUP and CCA Revenue Cycle staff by alerting them to gaps and lag time, including that between Pro Fee and HIM(as necessary) so that focused attention and resolution may be implemented collaboratively.

Communicates with Revenue Cycle leaders to proactively address any impact the professional fee coding work and projects are impacting the departments and overall corporate revenue integrity.

Participates in all meetings related to the revenue cycle at each of the entities representing corporate CFA and communicating with senior management all significant findings and statuses.

Assists with facilitating any case and session completion activities as necessary in coordination with the Coding Managers, Coordinators, Analysts, and Auditors; i.e. contacting department revenue cycle leads and IT for providers missing default department for revenue, investigating APP billable status, following up on vendor inquiries that impact charge lag.

Assists with the month end close out and weekly tracking of WQ inventory to meet revenue cycle goals as needed.

Responsible for tracking Continuing Education credits to maintain professional credentials.

Adheres to the American Health Information Management Association code of ethics.

Help lead the operations, education, audit efforts for the professional fee coding and auditing team

Using analytics and industry trends, customize coding operations, education, audit plan/strategy to incorporate team and health system needs

Collaborate with other CFA Coding Managers to develop a program to meet the needs of the department as well as the organization

Ensure the appropriateness and completeness of new hire onboarding

Develop and regularly update the Professional Fee Coding Manual to assist in communication of coding guidance to internal and external coders and auditors

Provide education to coders and auditors by email, in person as well as remote/recorded sessions, as appropriate

Regularly monitor, track and trend coding accuracy

Regularly monitor and update the CFA coding staff hours and assignments to meet the needs of the organization (CPUP and PMMG) as well as communicate to internal and external customers’ volume reduction plans as appropriate

Ensure 95% accuracy or higher in coding and auditing

Ensure productivity standards are met by coders and auditors

Provide regular 1:1 feedback to coders and auditors

Develop, implement and regularly optimize coding academy (coding pipeline) for professional fee coding team

Performs duties in accordance with Penn Medicine and entity values, policies, and procedures

Other duties as assigned to support the unit, department, entity, and health system organization

Credentials:

+ Certified Professional Coder (Required)

+ RHIA or RHIT or CCS-P. (Preferred)

Education or Equivalent Experience:

+ Bachelor's degree. (Required)

+ 4+ years of experience coding and auditing inpatient and outpatient medical records. (Required)

+ 2+ years of supervisory or management experience. (Required)

+ 3+ years of teaching experience. (Preferred)

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

REQNUMBER: 288640