We have an exciting opportunity to join our team as an Manager- Revenue Management Auditing
In this role, the successful candidate will support the Revenue Management Initiatives (RMI) department through the identification and execution of special projects identifying areas of increased net revenue opportunities. The Manager will have direct supervisory responsibilities of Clinical Charge Auditors to include managing day to day activities, monitoring work flow and volume, and providing guidance and coaching. Responsible for execution of charge capture performance improvement initiatives in conjunction with clinical departments, as well as creating and delivering charge capture training as required. The Manager is responsible for ensuring quality assurance of clinical chart audits and coding reviews. This position reports directly to the Associate Director, RMI.
Develop criteria for quality assurance reviews and metrics for monthly monitoring and reporting.
Provide consistent constructive feedback to the charge and code based auditors in order build knowledge and understanding. Develop and provide training on identified areas of concern or new areas for charge capture opportunity.
Oversee that charge capture protocols are up to date and accurately reflect charging practices of clinical areas. Researches and mitigates discrepancies in charging practices in conjunction with the auditor.
Routinely review data to make monthly observations and recommendations in order to prevent future revenue losses. Prepare reports and executive summaries as required by management regarding audit results, process improvement recommendations, and systemic billing errors.
Coordinate with auditors in the development and implementation of process improvement projects including: consulting with clinical departments, data gathering, preparation and delivery of presentations.
Investigate and document any potential for new programs and product development. Keep on top of charge capture opportunities. Develop and implement new projects for compliance and revenue enhancing initiatives.
Assist with development of departmental program planning, strategy, and goals for increased revenue reimbursement.
Perform data collection, tracking and analytical duties to respond to key issues, increase reimbursement and process efficiency. Support decision making process of leadership from multidisciplinary perspectives.
Manage relationship with Quality Assurance vendor.
Gain knowledge, be familiar with chart audit process across multiple service areas.
Assist in the development of training materials as needed.
Develop and maintain productivity standards for areas of direct responsibility, monitor adherence to those standards. Provide coaching and feedback to staff in areas of responsibility and complete probationary and annual performance appraisals for staff.
Interview prospective employees, make recommendations as to their abilities vis a vis the needs of the department.
Coordinate onboarding of newly hired team members.
Monitor staff attendance and punctuality, maintain timekeeping system for staff. Maintain records of staff attendance for all mandatory training sessions. Counsel employees when performance does not meet standard in an effort to improve the areas of deficiency before disciplinary action is required. Perform assigned duties efficiently, participate in other related duties as required.
Bachelor’s degree (or equivalent) in a Healthcare related field, Finance, Management or related field, and a minimum of 5 years of related experience, or an equivalent combination of education and work experience.
Management/supervisory experience required.
Previous auditing, project management, or nursing experience is preferred.
Excellent interpersonal, communication, organizational, and analytical skills are required.
Conversant with MS Office programs including Word, Outlook, and Excel
Experience with electronic health record documentation and Revenue Cycle software applications, such as EPIC enterprise system.
Be familiar with hospital billing and revenue cycle operations/functions.
Knowledge of CPT and ICD-10 coding preferred.
Familiarity with insurance terms (i.e. HMO/PPO, EOB, stop loss, etc.) is preferred.
Knowledge of regulatory agencies requirements (CMS, Medicare, & Medicaid) is preferred.
Able to understand hospital bills, hospital charge master, and ancillary department functions.
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision.
NYU Langone Health, a world-class patient-centered integrated academic medical center, is one of the nation's premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals – Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, one of only five hospitals in the nation dedicated to orthopaedics and rheumatology; and Hassenfeld Children's Hospital, a comprehensive pediatric hospital supporting a full array of children's health services across the medical center – plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center's tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research. For more information, go to www.nyulangone.org.