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Job Description

Business Unit: Rush Medical Center

Hospital: Rush University Medical Center

Department: Revenue Cycle Revenue Integrit

**Work Type:** Full Time (Total FTE between 0.9 and 1.0)

**Shift:** Shift 1

**Work Schedule:** 8 Hr (7:00:00 AM - 3:00:00 PM)

Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits).

**Pay Range:** $41.44 - $67.44 per hour

Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Summary:

The manager of provider education, working in a remote environment will lead the provider education staff to promote documentation and code selection accuracy along with appropriate, compliant reimbursement. This manager serves as a resource for clinical documentation education, coding, charging, denials prevention, provider audits and has an advanced understanding of medical necessity, compliance, and quality measures. This leader promotes a positive culture, efficiency and the use of Epic automation and ancillary coding software solutions. The manager will exemplify the Rush mission, vision and values and act in accordance with Rush policies and procedures.

Other information:

Required Job Qualifications:

• Bachelor’s or Associate degree in health information technology, healthcare management, nursing, finance, or other related fields or 10 years of industry experience in lieu of a degree

• AHIMA or AAPC Certification (such as CCS, CCA, CPC, COC, CPMA, RHIT or RHIA)

• Five years of experience with code auditing or coding education in hospital (HB) or professional (PB), along with ICD-10/CPT/HCPCS codes, Modifiers, NCCI edits, and compliant coding methodologies

• Experience with Epic reporting and dashboards

• Demonstrated ability to communicate clearly and effectively

• Proficient in Microsoft Office, Excel, PowerPoint, and Word skills

• Strong interpersonal skills necessary for the communication and training of Revenue Integrity concepts

• Ability to perform multiple tasks with excellent time management skills

Preferred Job Qualifications:

Epic Certified

Physical Demands:

**Disclaimer:** The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

Responsibilities:

1. Lead and direct provider education staff while acting as a resource for the team’s work of connecting regulations, compliance standards, clinical documentation, quality measures and payor policy to revenue codes, modifiers, ICD-10, CPT/HCPCS, and other codes, with clinical documentation, to ensure accurate claims.

2. Keeps abreast of changing industry and regulatory requirements and communicates changes to impacted leaders, staff, while collaborating with other areas and Epic for coding, charging, reimbursement, quality, or clinical documentation issues, to solve, maintain a record of issues, and communicate solutions and improvements.

3. Proactively lead efforts to identify regulatory trends, opportunities within Rush, and lead performance improvement efforts through multi-disciplinary teams to streamline processes, enhance automation, prevent denials, train staff, ensure timely claims submission, and promote accuracy using short-term and long-term planning.

4. Identify and create educational opportunities with continuous improvement across the Rush system focusing on the combined strategic priorities of the clinical staff and revenue cycle.

5. Manage provider education curriculum based on evolving specialty care, coding trends, and regulatory changes.

6. Monitor industry trends, denial trends, and documentation patterns to inform training needs and process enhancements and then collaborate with a variety of stakeholders to innovate solutions.

7. Partner with Compliance, Quality, Continuous Documentation Improvement (CDI) legal, Coding, Revenue Integrity, and Internal Audit to optimize Rush’s regulatory adherence in revenue cycle

8. Ensure adherence to federal, state, and payor regulations, while driving compliance by ensuring the team has accurate work, optimizing the Epic automation functionality, charging and coding regulations are applied, and the middle revenue cycle initiatives are carried out per the revenue cycle goals and KPI’s

9. Create and supervise proactive workplans for code audits and reporting of results that are the foundation for coding education plans.

10. Lead efforts to identify areas of strengths and concerns for individual coders and teams to ensure optimized accuracy for the organization.

11. Orchestrate routine external audits with outside agencies and participate in internal compliance reviews.

12. Collaborate with CDI leaders to round out the organization’s strategic approach for coding excellence.

13. Strategically assigns work and ensures cross-training occurs to expand organizational goals and personal growth of staff members and act as a resource on related documentation improvement projects.

14. Identify and trouble-shoot coding, reimbursement, quality, or clinical documentation issues, collaborate with ancillary departments and Epic build team to resolve, maintain a record of issues, and communicate solutions and improvements

15. Develop, update and implement job standards, job duties, job aids, departmental policies, and performance appraisals for all areas of responsibility. Engages in development and growth of self and the team

16. Collect, interpret, and communicate performance data using various tools and systems, while also using this data to make decisions on how to achieve performance and budgetary goals

17. Responsible for interviewing, hiring, orienting new team members (staff & temp), staffing, performance management and development of staff. Counsel and disciplines employees, when necessary, in accordance with department and/or organizational policies. Maintains staff schedules, timecards, and payroll with fiscal responsibility.

18. Prepares monthly analytics reports, dashboards information, and other statistics along with assisting in strategic planning

19. Facilitate a positive culture that exemplifies growth-minded practices, leadership, and industry-best practices

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

**Position** Mgr Provider Education

**Location** US:IL:Chicago

**Req ID** 22643