The Department of Neurology has an opportunity available for a revenue specialist to assist department leadership with enhancing policies and protocols to optimize reimbursement. The appointed candidate will learn and understand each unit’s billing procedures to further assist in revenue optimization.
The candidate will assess payer rules and regulations for hospital and physician billing, and provide medical school financial analysis for the department using their expert-level experience with regulatory requirements
The successful candidate will provide information to administrative managers, chief department administrator and chair regarding insights and opportunities related to reimbursement practices.
This position will be located at Michigan House on Commonwealth Blvd. (near US-23 and Plymouth Rd.), but will require occasional visits to ambulatory care units.
- Assist with the development and implementation of policies, procedures and system improvements, ensuring compliance with regulations and requirements across multiple clinical specialties.
- Assist providers by answering questions regarding documentation.
- Keep providers updated on billing/coding changes and/or compliance issues.
- Ensure inpatient activities and outpatient charges are billed appropriately.
- Train mid-level providers in daily care billing, providing training materials as needed.
- Function as a MiChart super user, providing assistance as necessary.
- Understand and interpret hospital reimbursement rules by payer and clinical specialty.
- Monitor complex billing codes on a regular basis to ensure that appropriate charges and modifiers are being filed.
- Analyze CMS, Medicaid and other payer regulations related to billing for multiple clinical specialties and implement processes to ensure compliance with regard to specific payer system requirements.
- Work with billing unit staff and payer representatives, facilitating all components (identifying, analyzing, advising and resolving) of reimbursement and underpayment issues.
- Act as a liaison with coding team for follow up, freeing-up faculty to continue with patient care, research and education missions (i.e. respond to inquiries from and provide follow-up assistance to providers regarding billing or charge capture issues).
- Monitor open encounters and assist providers with completing documentation as requested.
- Monitor and report on billing and reimbursement trends.
- Prepare special periodic reports, including financial summaries, quality reporting and activity statistics.
- Develop reports showing total activity, total billed and unbilled by provider. Complete a root cause analysis for any unbilled activity.
- Analyze business operations pertaining to billing workflow, ensuring efficiency and proper protocol.
- Provide input on operational changes, enhancing revenue capture/generation.
- Assure compliance with institutional goals, objectives, policies, standards and guidelines.
- Stay current on coding changes/updates, attend training and obtain certification(s) as necessary.
- Assist department with revenue projections as part of the ROI analysis for new clinical programs.
- Provide support during budget process, up to and including all aspects of ambulatory care and hospital budgets.
- Additional projects/duties as assigned.
A Bachelor’s degree in Business Administration, Health Care Administration or related field and 1 year of experience is required.
Progressively responsible experience in hospital medical billing and collection, or third party claims settlement and regulation is necessary.
- Excellent written, verbal and interpersonal communication skills.
- Ability to cohesively present information to a variety of constituents including faculty and staff.
- Experience problem-solving and manipulating large data sets using Microsoft Excel (or similar programs) to create reports for department leadership.
- Extensive knowledge of cross-departmental hospital and physician billing policies, third party payer processes and regulatory and accreditation requirements.
- Strong knowledge of systems related to revenue cycle and health system billing, including MIChart.
- Significant experience using third party payer portals and methods of obtaining e-referrals.
- Consistently reliable attendance.
- Demonstrated ability to perform reliably within a team environment.
- Knowledge of computer applications.
- Knowledge of University policies and procedures.
- Master’s Degree in Health or Business Administration or an equivalent combination of education and experience required. Considerable administrative experience necessary.
- Three to five years’ experience working with providers on billing and reimbursement related issues, and an expert-level understanding of coding patterns and rules.
- Experience with initiating and developing policies and procedures to enhance revenue capture and margin enhancement including the ability to prepare projections, analyses and plans for operational improvement.
- Ability to assist in the organization of cross-departmental billing and collections including the monitoring of charges and collections and initiating corrective action when necessary.
- Experience with team building and knowledge of incorporating Lean principles into daily work.
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act.
Michigan Medicine 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 our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Job openings are posted for a minimum of seven calendar days. This job may be removed from posting boards and filled anytime after the minimum posting period has ended.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.