Full Time 40 hours Grade 055 Emergency Billing Schedule 8 AM-5 PM Responsibilities Position Summary: Manages the Billing Department of Emergency Medicine under the general direction of the Program Administrator and with significant latitude for independent judgment, is responsible for the billing operations of the Department of Emergency Medicine, comprising annual charges of over $100,000,000 in faculty practice and hospital services. Supervises department billing staff, Credentialing Coordinator and Sr. Analyst staff (20 FTEâ™s), including hiring, training and performance evaluations. Reviews and synthesizes information from CMS and insurers related to relevant changes to determine, develop, implement and monitor policies and procedures to ensure accurate and efficient charge entry, payment posting, accounts receivable management and reporting. Accountable for ensuring compliance with federal and other regulations concerning medical billing procedures and practices. Develops and maintains reports on billing activities and communicates results to Program Administrator, Department Chair, Hospital Leadership and faculty. Serves as liaison and represents the department with the MFG Business Office, SMH Patient Accounts, HIM and other University departments and areas. Performs non-routine analyses on related issues and participates in various projects as directed by the Program Administrator. Responsibilities Supervision of Billing Staff Supervise billing staff including hiring, training, and performance evaluations. Provide leadership and training of staff on billing policies and third party contracts.Ensure compliance with federal and other regulations concerning billing policies and procedures. Assign and monitor work flow to maximize efficiency.Provide opportunities for cross training and development of staff skills. Determine, develop, implement, and monitor policies and procedures to ensure complete and efficient charge entry, payment posting and accounts receivable management. Determine departmental review processes to insure compliance and productivity of billing staff. Handle non-routine claim and payment issues. Monitor accounts receivable and collection rates and take appropriate action to maximize reimbursement. Serve as liaison to other University of Rochester departments and third party payers. Defines organization structure required to meet departmental and hospital goals. Reporting and Analysis Develop and maintain reports and communicate the results of billing operations to the Program Administrator. Perform non-routine analysis on billing and revenue related issues. Analyze billing systems and procedures and recommend changes for process improvements in order to maximize revenue.Update systems to keep current fee schedules and CPT/ICD10 codes current and billable. Regulatory and Insurer Compliance Review CMS and insurer regulations and policies to incorporate into EM procedures and patient documentation as needed. Staff Training Train staff in proper billing and coding procedures and compliance issues related to third party billing. Credentialing Responsible for oversight of credentialing unit responsible for the initial credentialing, and recertification of over 200 physicians in the Medicine Unit.Ensures policies and procedures are in place to enable new and existing providers the ability to become credentialed with payers and URMFG timely to ensure maximum reimbursement. Reporting Oversee Senior Analyst to ensure billing activity reports for Medicine unit meet the needs of the divisions, Unit Chiefs and Chief Administrative Officer and are done accurately and timely through the use of IDX, Analyzer and various accounting tasks.Ensure billing staff receives monthly reports on billing status/activity in each division.Update and develop reports as necessary in conjunction with Senior Analyst to meet the needs of the division on a monthly basis. Budgeting Develop and monitor departmental budget Special Projects Participate in and contribute to various projects as assigned by the Department Chief Administrative Officer including URMFG Billing Managers forums and centralization initiatives. Requirements Bachelorâ™s degree or 5 years of experience as outlined above. Requires strong interpersonal skills and the ability to communicate effectively with staff, faculty, Medical Center administration, and representatives of various third party payers. Working knowledge of billing systems and reporting systems required. Direct experience in medical fee billing required. CPC, CMBS credentialing preferred. Certification as a Certified Medical Billing Instructor desirable.
Internal Number: 1160485769
About University of Rochester
The University of Rochester is one of the country's top-tier research universities. Our 158 buildings house more than 200 academic majors, more than 2,000 faculty and instructional staff, and some 11,100 students.
Learning at the University of Rochester is also on a very personal scale. Rochester remains one of the smallest and most collegiate among top research universities, with smaller classes, a low 10:1 student to teacher ratio, and increased interactions with faculty.