Penn State Health - Penn State Health Corporation

Location: US:PA: Hershey
Work Type: Full Time
FTE: 1.00
Shift: Day
Hours: 8:00a  -  4:00p
Recruiter Contact: Garrett C. Kieffer at gkieffer@pennstatehealth.psu.edu

SUMMARY OF POSITION:

**Remote Position**

This position serves as the principle revenue cycle person of assigned service line. He/she supports the revenue cycle functions from start to finish by collaboration, analysis, process mapping and education with support area providers, clinical and operations leadership, and revenue cycle subgroups. This position influences all charges though charge capture process mapping, risk mitigation through education and problem solving through analytics. Collaboration occurs between RIPM and operations, clinicians, IS, compliance, finance, revenue cycle subgroups, their leadership and team members. The RIPM is viewed by the service lines/departments as the leader of the departmental revenue cycle in general and directed our focus to where it was needed to optimize charge/cash capture. This position reports to Team Manager Revenue Integrity and the Revenue Integrity Support Services Leadership.

ESSENTIAL DUTIES: The percentage of time spent performing essential functions is 95%. Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties: 

• Serve as expert for Special Projects (end of PHE, yearly updates, cross-entity management) with regard to regulatory changes, internal changes and unexpected coordinated projects. 
• Serve as subject matter expert on developing, documenting, and validating charge capture process workflows for assigned department(s), and understand/coordinate/develop associated charge reconciliation processes for each process flow and monitor regularly. 
• Request and provide post-implementation validation of billing system edits to ensure claims contain appropriate codes, activity-type, revenue codes and functionality. 
• Manage requests for new charges, providers, services, and prices through point-of request through charge validation when build/addition is complete. Report on additions routinely while working with Finance (pricing) and CDM (Chargemaster team) internal workflows. 
• Serve as expert on CMS regulations, OIG hot topics, final rule updates, and payer policies on new and existing services, including who can perform, locations, how to bill, codes to use, documentation required to support, supervision guidelines, etc. and make recommendations to the clinicians and department. 
• Coordinate information on charges, regulations, system set-up, charge capture for technical charge setup, validation and compliance for all Penn State Health hospital and clinic locations by gathering information from government and payer websites, practitioner clinical workflow, billing system needs, and practitioner charge capture methods. 
• Serve is liaison between IT and practitioners by coordinating clinical EMR needs with informaticists with goal to improve the provider?s experience with the EMR; reporting leadership routinely on the outcome of improvement projects.
•  Serve as the revenue cycle expert and compliance liaison with every new provider to educate on documentation and coding. Audit every new provider using a sample of 10 random encounters. Provide findings and education. Track results for continued improvement. Deliver results of any provider-specific audits and work with the provider to develop a corrective action plan if required.
• Analyze and access benchmarking analytics (Vizient) to identify outliers (risk/revenue opportunity) and share data with the department. Provide analysis and feedback for necessary documentation changes to mitigate risk or optimize opportunity. 

MINIMUM QUALIFICATION(S):

• Bachelors, or equivalent work experience
  
• CPC (AAPC Certified Professional Coder) ? or equivalent from another organization or able to be obtained within one (1) year of employment. 
• Five (5) years in a role involving middle and back end Revenue Cycle activities, front to end, with direct interaction with providers and operations.
  

PREFERRED QUALIFICATION(S):

• Previous management level experience in a healthcare setting applicable to revenue cycle ? either managing a team or project management of processes. 
• Experience in Coding, Billing Denials, Edits, Appeals, Utilization Management, Charge Capture, Compliance/Revenue Cycle Auditing. 

WHY PENN STATE HEALTH?

Penn State Health offers exceptional opportunities to learn and grow, exposure to a wide patient population, and the ability to provide individualized, innovative, and specialized care to patients in the community.

Penn State Health offers an exceptional benefits package including medical, dental and vision with no waiting period as well as a Total Rewards Program that highlights a few of the many additional offerings below:

• Be Well with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton).
• Be Balanced with Generous Paid Time Off, Personal Time, and Paid Parental Leave.
• Be Secured with Retirement, Extended Illness Bank, Life Insurance, and Identity Theft Protection.
• Be Rewarded with Competitive Pay, Tuition Reimbursement, and PAWS UP employee recognition program.
• Be Supported by the HR Solution Center, Learning and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling.

WHY PENN STATE HEALTH CORPORATION?

There are many ways to make an impact with one of the leading research, teaching, and clinical healthcare systems in the country. Through a combination of operational, corporate, clinical, and nonclinical roles, we are advancing excellence and innovation in health care together as one team. As Penn State Health continues to evolve for the future, we are committed to hiring dedicated employees who are passionate about delivering the best possible support across our entire integrated health system. 

Within Penn State Health?s Shared Services Entity, we encourage our employees at every turn to continue their education and advancement. Numerous opportunities are available for professional development and career growth. 

YOU TAKE CARE OF THEM. WE?LL TAKE CARE OF YOU. State-of-the-art equipment, endless learning, and a culture of excellence ? that?s Penn State Health. But what makes our healthcare award-winning? That?s all you.

This job posting is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. Eligibility for shift differential pay based on the terms outlined in company policy or union contract. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.

Penn State Health is fundamentally committed to the diversity of our faculty and staff. We believe diversity is unapologetically expressing itself through every person's perspectives and lived experiences. We are an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information. 

Union: Non Bargained

About Penn State Health

At Penn State Hershey, our mission is to enhance the quality of life and serve our community through improved health, the education of health professionals, and the discovery of knowledge. For us, service excellence is not only for our patients but also our employees. It means valuing each and every employee.

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