Clinical Revenue Supervisor
University of Chicago
The University of Chicago Practice Plan (UCPP) is the central organization that supports the clinical activity of nearly 750 clinically active faculty practicing at the University of Chicago. These clinically active faculty collectively form the University of Chicago Physicians Group (UCPG) which is located in Burr Ridge, IL. The University of Chicago Physicians' Group (UCPG) is a component of the physician practice plan for the University of Chicago. The UCPG department provides billing services for medical services provided by University physicians and manages the accounts receivable and reporting processes for the Biological Sciences Division (BSD) departments. Each physician is a faculty member and is based in a specified department in the BSD. The University of Chicago is a private institution encompassing the undergraduate College, six professional schools (Business, Law, Divinity, Public Policy, Medicine and Social Service Administration), four graduate divisions (Biological Sciences, Humanities, Physical Sciences, and Social Sciences) and the University of Chicago Medical Center. The broader University enterprise includes Argonne National Laboratory, Fermilab, and Yerkes Observatory. The Biological Sciences Division (BSD) includes the Pritzker School of Medicine, approximately 20 academic units, degree granting committees, and research centers and institutes. The BSD is located on the University's main campus in Hyde Park, ten minutes south of downtown Chicago. BSD's patient care operations are conducted primarily at the University of Chicago Hospital and clinics, which share the same campus.
About the Department
The Analyst of DCAM AR will support the Manager of DCAM for the oversight physician claims billed through our hospital outpatient clinics. These role will have oversight of the effective operations of claim submission, no response, denial follow-up, appeals, and payer relations/escalation. This role will have a combination of internal and external staff reporting to them. They will supervise the daily activities of this operations team. Sets priorities for the team to ensure tasks are completes and coordinates work activities with other supervisors. Through this work they will solve complex problems related to revenue cycle operations as well as ensure successful billing, collection, and compliance activities within the department.
Oversees the AR follow-up and denial resolution process with minimal direct oversight.
Proactively reviews current workflows for AR resolution with the intention to improve, implement, communicate and maintain an efficient AR resolution process.
Identifies and resolves the systematic and/or operational root causes of denials and outstanding AR.
Oversees and manages the AR follow-up work queues (WQ) and proposes both short and long-term enhancements that support business needs.
Assists manager with maintaining payer scorecards, creating payer meeting agendas, and communicating issues to provider representatives.
Works with the payers on escalated account resolution, identifies and submits high-complexity and other escalated payer projects.
Creates simple to moderately-complex reports that are necessary for payor projects using a variety of business tools.
Proactively reviews payer communication, initiates payer policy and rule change implementation, and proposes changes to front-end or back-end edits.
Communicates clearly and professionally with the other UCPG units, clinical departments, external vendors, and payers in effort to build partnerships that result in denial resolution and prevention.
Provides AR follow-up expertise to other UCPG and UCM business units as needed.
Works closely with the Coding Education team to suggest opportunities for coder and provider training.
Assists clinical departments in resolving escalated AR and denial issues.
Works with Hospital Billing (HB) team on AR issues that cross between PB, HB, or SBO applications.
Provides AR follow-up training to existing and new AR follow-up staff.
Completes quality audits for denial and AR resolution activities.
Creates denial Appeal, Reconsideration, and Letter of Medical Necessity Letter templates and trains staff in effectively using these templates.
Creates workflows and assists manager in developing and documenting policies and procedures.
Provides support to UCPG and external entities for any AR issues.
Provides root cause analysis of AR issues and denials and implements tools and solutions to reduce denials and other manual AR follow-up work.
Provides direct support to AR resolution in effort to better identify trends and new issues.
Assists the manager in monitoring and trending AR and denials, provides root-cause analysis, assists in root cause resolution and identifies opportunities to improve workflows.
Supervises the day-to-day activities of the Clinical Revenue support staff.
Prepares departmental compliance efforts by participating in training sessions, performing audits, and promoting an understanding of procedures, policies, and expectations.
Has a moderate/solid understanding of coding procedures, workflow issues, billing infrastructure, and performance of Clinical Revenue staff. Informs department administrators, physicians, and Coder/Abstractors of regulatory changes.
Participates and may lead in training sessions, performing audits, and promoting an understanding of procedures, policies, and expectations in promotion of compliance efforts.
Performs other related work as needed.
Education:Minimum requirements include a college or university degree in related field.
Bachelor’s Degree or equivalent work experience.
Experience with physician revenue cycle specific AR follow-up and denial resolution.
Experience with diagnosis and CPT coding terminology.
Experience with charge correction activities.
Experience using physician billing/revenue cycle software and electronic medical records system.
Proven ability to effectively develop and introduce procedures and processes to others both within Department and with Manager/individuals in other UCM departments.
Previous EPIC experience.
PC experience and MS Office (Word, Excel, PowerPoint).
Confidentiality/discretion must be maintained at all times.
Ability to handle multiple concurrent tasks in a competent and professional manner in a fast paced atmosphere.
Ability to understand medical terminology/documentation.
Ability to solve problems independently with limited direction from the supervisor.
Ability to work for long periods of time in a sitting position, or at a keyboard.
Ability to bend/kneel to access files in filing cabinets or storage boxes.
Ability to drive or commute to various sites for meetings.
Ability to work flexible hours.
Demonstrated knowledge of third-party payer systems and related rules and regulations.
Demonstrated analytics and report knowledge.
Comprehensive working knowledge word processing, database, and spreadsheet software.
Demonstrated knowledge of billing systems.
Ability to use electronic billing system.
Exceptional organization skills.
Excellent written and oral communication skills.
Office setting, requiring sitting or standing at a computer for long periods of time.
This role is also eligible to work remote with ongoing approval by the University and manager. For this reason, the individual will also need a secure location at their home to work including access to high-speed internet.
$60,000 - $75,000 per year.
Cover Letter (preferred)
When applying, the document(s) MUST be uploaded via the My Experience page, in the section titled Application Documents of the application.
Scheduled Weekly Hours
Drug Test Required
Health Screen Required
Motor Vehicle Record Inquiry Required
The University of Chicago is an Affirmative Action/Equal Opportunity/Disabled/Veterans and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender, gender identity, national or ethnic origin, age, status as an individual with a disability, military or veteran status, genetic information, or other protected classes under the law. For additional information please see the University's Notice of Nondiscrimination.
Staff Job seekers in need of a reasonable accommodation to complete the application process should call 773-702-5800 or submit a request via Applicant Inquiry Form.
We seek a diverse pool of applicants who wish to join an academic community that places the highest value on rigorous inquiry and encourages a diversity of perspectives, experiences, groups of individuals, and ideas to inform and stimulate intellectual challenge, engagement, and exchange.
All offers of employment are contingent upon a background check that includes a review of conviction history. A conviction does not automatically preclude University employment. Rather, the University considers conviction information on a case-by-case basis and assesses the nature of the offense, the circumstances surrounding it, the proximity in time of the conviction, and its relevance to the position.
The University of Chicago's Annual Security & Fire Safety Report (Report) provides information about University offices and programs that provide safety support, crime and fire statistics, emergency response and communications plans, and other policies and information. The Report can be accessed online at: http://securityreport.uchicago.edu. Paper copies of the Report are available, upon request, from the University of Chicago Police Department, 850 E. 61st Street, Chicago, IL 60637.