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Job Summary

The Charge Capture and Revenue Optimization Manager plans and manages the operational activities of the Charge Capture and Revenue Optimization Department.  Directs day to day activities of the department and manages staff to ensure optimization of UMHS revenue for services rendered by the clinical enterprise. Makes decisions regarding the establishment of procedures to optimize revenue and reimbursement.  Responsible to ensure compliance to federal and other payer rules. Manages the team to ensure accurate and timely development and activation of the charge EAPs for both professional and hospital services.  

Responsibilities*

  • Provide support and guidance to staff responding to requests for new charges and revision of existing charge codes. Set quality standards for speed and accuracy.
  • Responsible to maintain a compliant professional and technical chargemaster by understanding the constant and continued regulatory and billing changes. Utilize available tools like Med Assets and coding and benchmarking databases
  • Work with Revenue Cycle and HITS MiChart leadership to ensure optimal integration of charge capture into clinical build and workflows.  Under your guidance, and with help from your leadership, your team will participate in the build, testing, and implementation support of charge capture methodologies.
  • Work with Revenue Cycle, HITS colleagues and key stakeholders to optimize MiChart processes related to charge capture, workflow and documentation purposes. Includes process analysis, re-engineering, business and technical solutions for both current and future business environments.
  • Monitor and oversee Point of Service, CCRO and Revenue Guardian Work Queues.  Maintain documentation of the build and workflow for these WQs.  Establish guidelines, performance metrics for staff and departments responsible to work these WQs. Determine root cause for high volume edits, revise edits as needed and work with users to improve charge reporting and workflows.
  • Develop staff expertise and competency for tracking revenue, identifying variances, determining root causes for variance, and assisting in the resolution of build and workflow issues affecting revenue
  • Actively participate and assist leading the Revenue Cycle Rules Advisory Committee. Collaborate with Revenue Cycle, departmental, and HITS staff to optimize revenue, maintain compliancy, reduce wasted effort and ensure coordination of rules.
  • Ensure proper facility rate setting policies and procedures are documented and followed. Participate in yearly strategic pricing Initiatives
  • Participate in charge integrity initiatives and revenue improvement by identifying areas of missed opportunity (missed charges or workflow inefficiencies) while staying compliant with state and federal regulatory guidelines. Oversee the appropriate coding of EAPs commensurate with national and local coding guidelines.
  • Ensure employee engagement through using the feedback provided by annual Employee Engagement Surveys. 
  • Insure appropriate training, education and feedback is provided to continue development of a competent, skilled workforce with strong team values and excellent communication skills.
  • Utilize Lean Principles to evaluate and improve processes.
  • Investigate and recommend technology and process improvements to increase staff efficiency.  Ensure technology and tools are used to their full capacity. 
  • Demonstrate knowledge and adherence to HIPAA privacy standards and ensure compliance with system PHI privacy practices by self and staff
  • Commitment to team development, communication and quality improvement throughout the Patient Customer Service process

Required Qualifications*

  • Bachelor’s degree in Business Administration or field related to healthcare
  • Proven ability to effectively manage a team composed of direct and indirect reporting relationships
  • Experience and knowledge of healthcare coding, state and federal regulations and reimbursement for both professional and hospital billing
  • Knowledge of and skill in the use of computers, external databases, and related systems and software, including Powerpoint, Word and Excel
  • Able to communicate effectively with team members and management
  • Detail-oriented, good organizational skills, analytical, strong problem solving/investigative skills, and ability to be self-directed
  • Demonstrate personal integrity, enthusiasm and empathy to staff, internal and external customers

Desired Qualifications*

  • 5 year’s minimum experience in Healthcare Management including significant experience in healthcare business systems, CDM team, coding and charge capture
  • Coding Certification- CPC, CPC-H or coding experience with certification obtained within first 12 months of employment
  • Knowledgeable and experienced with insurance plan payment practices and billing requirements.
  • Experience with Epic Electronic Healthcare Record,system.. Familiarity with charge EAP build, router/handler rules, WQ’s, hospital and professional billing and reporting

Mission Statement

The University of Michigan Health System improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally.  Our mission is guided by Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Application Deadline

Although the Posting End Date may indicate otherwise, this job opening may be filled and closed any time after a posting duration of seven calendar days.

U-M EEO/AA Statement

The University of Michigan is an equal opportunity/affirmative action employer.

U-M EEO/AA Statement

The University of Michigan is an equal opportunity/affirmative action employer.