"YM Workers Comp Revenue Cycle Manager"

Overview

Under the direction and supervision of the Associate Director of Special Programs/Cash posting, or his/her designee, the ideal candidate will be a subject matter expert in revenue cycle management with specialized expertise in Workers’ Compensation and lead a team of staff and will be responsible for developing, implementing and monitoring policies and procedures to optimize the physician reimbursement and ensure compliance of the Program for Yale Medicine. This individual will communicate with all clinical departments within the Central Business Office, including Billing and Coding, as well as third party payors, contracting staff, compliance department, and attorney offices. The candidate will lead ongoing analysis of Workers’ Compensation billing and collections, drive strategic growth of Yale Medicine’s Workers’ Compensation program, and proactively identify and resolve coding, billing, and payer/contracting issues that affect revenue cycle performance.

Required Skills and Abilities

1. Ability to analyze and interpret detailed reports, develop clear conclusions, and summarize findings; ability to perform quality assurance on individual accounts, monitor and analyze clinical department and payors key performance indicators and metrics for revenue cycle.
2. Ability to work effectively as a team member; demonstrated team-building skills and ability to develop good working relationships with co-workers and Yale Medicine clinical departments.
3. Ability to work, plan, research, and conduct projects independently with minimal supervision.
4. Ability to organize and prioritize workload to manage multiple tasks and meet deadlines, excellent attendance, and reliability.
5. Excellent written and oral communication skills with demonstrated interpersonal ability to facilitate a team-based approach.

Preferred Skills and Abilities

1. Comprehensive knowledge of ICD-10, CPT-4 and HCPCS coding, medical terminology, and third-party reimbursement policies.
2. Proficiency with MS Word, Excel, and PowerPoint.
3. Proficiency with Epic Practice Management System and EMR.
4. CPC certification, work related experience in a private or academic setting.

Principal Responsibilities

1. Reviews and determines staffing needs, job posting requirements, salary guidelines, and labor agreement interpretations for exempt and non-exempt staff in one or more functional department of the University.
2. Manages the administrative support needs for exempt and nonexempt staff and provides recommendations, improvements, solutions and assistance as needed.
3. Manages and monitors technology needs, conducts inventory, and system requirements for the assigned departments.
4. Develops and prepares budgets, financial forecasts, and financial analyses and the actual vs. budgeted performance reports for the departments.
5. Manages the use of facilities in one or more departments including office space, work stations, equipment, and office supplies.
6. Manages administrative support for activities of one or more departments to ensure timely completion of projects.
7. Manages and coordinates training sessions for assigned departments when new policies or practices are adopted.
8. Ensures compliance with University and federal regulations as they apply to the assigned departments.
9. Identifies, plans, and develops administrative policies for the assigned departments.
10. Assists in reviewing and implements University and departmental policies as they pertain to the administrative functions of the assigned department.
11. Assesses and makes recommendations regarding staff development and staffing levels.
12. Monitors, develops, plans, and executes systematic research on user requirements through such mechanisms as surveys, interviews, focus groups and competitive analysis.
13. Manages a staff of exempt and non-exempt employees.
14. May perform other duties as assigned.

Required Education and Experience

Bachelor’s Degree in related field and 5 years of experience or an equivalent combination of education and related experience.