Penn State Job Catalog

The Medical Revenue Cycle Manager provides direction and leadership for the financial health of University Health Services through the management of the revenue billing cycle; supports end-to-end revenue cycle functions through collaboration, analysis, process mapping, and education in partnership with support area providers, clinical and operations leadership, revenue cycle subgroups, and third-party stakeholders; ensures the timely resolution of billing issues; oversees revenue cycle processes, workflows, and systems; communicates with insurance providers and external vendors to maintain contracts and ensure compliance.

• Manage the revenue cycle process and billing team; oversee the entry and coding of billing information through submittal to the third-party management company; consult and provide solutions for complex billing issues; determine and implement best practices to ensure an efficient and accurate billing process
• Develop charge capture workflows to optimize billing processes and ensure accuracy; oversee charge reconciliation processes to ensure accurate and optimized billing; ensure billing procedures are compliant with professional, state, and federal regulations
• Lead and serve as subject matter expert on special projects related to regulatory updates, cross-entity initiatives, internal improvements, and emergent revenue cycle efforts
• Direct the processing, validation, and alignment of new providers, services, and pricing
• Oversee third-party revenue cycle vendors and insurance payors, including contract negotiation, performance monitoring, compliance, and stakeholder coordination
• Serve as compliance liaison to providers; lead the annual audit process, deliver education based on findings, and track follow-ups and corrective actions
• Coordinate with the third-party management company to correct any billing issues resulting in denials; ensure appropriate communication and follow-up with clinical staff
• Analyze and facilitate contracts with insurance companies in order to maintain compliance and maximize revenue
• Advise on best practices to maintain the accurate and timely entry of billing information in the electronic health record system
• Test and validate system updates to ensure regulatory and compliance standards, including proper coding and revenue code alignment
• Develop revenue cycle performance reports
• Analyze benchmarking data to identify risks and opportunities; contribute to forecasting, budgeting, and documentation improvements
• Hire, train, coach, supervise, schedule, and evaluate employees; identify and deliver professional development opportunities; oversee workflows and assign priorities

Level:

– Manager

Base Description:

– Manages direct reports where primary duty is the management of a working unit.

Level Summary:

– Demonstrates proficient ability in work design, project management, financial planning and development of goals for accomplishing unit assignments. Reviews and guides work to ensure conformity to policy and effective approaches. Evaluates employee performance and recommend development opportunities. Demonstrates ability to coach employees. Presents and communicates key university indicatives and connects it to unit contributions. Provides broad guidelines. Develops, evaluates, enhances, and/or implements quality improvement practices. Recommends innovative solutions.

Supervisory Responsibilities:

– Oversees a team (typically 4 or more; no fewer than 2) full
– time direct reports of individual contributors and/or first level supervisors.

Fiscal Responsibilities:

– Monitors and tracks department/area budget
– May plan, forecast, and/or assist in developing budgets
– May have final signature authority for specific area

Problem Solving:

– Encounters varied and complex problems
– Helps to develop creative and/or novel approaches to resolve problems that are difficult in nature but within limited scope
– Modifies, adapts, or refines guidelines if necessary to resolve issues or problems

Independence of Action:

– Works independently on complex or strategic assignments
– Uses existing practices and advanced working knowledge to determine appropriate work methods for the team
– Reviews completed work of others for conformity to policy, and effectiveness of approach
– Delegates advanced tasks to others

Communication and Collaboration:

– Communicates with both internal and external audiences
– Collaborates closely with team members and various areas across the University
– Prepares written and/or verbal presentations or proposals on complex issues and delivers to a broad variety of audiences
– Communicates key university initiatives and how unit’s work contributes to their achievement
– Presents ideas, concepts and instructions in a clear manner, and uses persuasion and negotiation to build consensus and cooperation
– Establishes and maintains networks to facilitate successful communication among units

• Comp Grade – 10
• Minimum – $61,800.00
• MidPoint – $75,700.00
• Maximum – $89,600.00

• Business process management
• Cashiering
• Contract management
• Cultural competency
• Customer Service
• Data reporting
• Database management
• Medical billing
• Records management
• Regulatory compliance
• Student account management
• Vendor management