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Providence Health & Services RIS Revenue Cycle (RC) Compliance Senior Manager Coding/Billing Data Analytics Automation in Portland, Oregon

Description:

Providence St. Joseph Health is calling a Compliance Senior Manager Coding/Billing Data Analytics Automation to our location in Renton, WA.

We are seeking a Compliance Senior Manager Coding/Billing Data Analytics Automation to manage, coordinate and escalate implementation and automation of enterprise risk based data analytic tools throughout PSJH to maximize efficiency in charging/billing/coding risk assessment and prevention. Position will have scope over the whole system when it comes to risk sensing for coding compliance Provides system wide data analytics during the current COVID -19 disaster/pandemic and future crisis/disaster events as relates to Providence's Fema applications following the constant changing Federal and State regulations timely and comprehensively. Position will have oversight for program that reviews all multi-billion dollar submissions - integral and critical to PSJH mission. Position will be responsible for communication with CEs, RCEs, CFOs, etc. across the organization. High level and confidential information. Position will be responsible for implementation of a comprehensive systemwide compliance plan for revenue cycle interacting with leadership in HIM, Revenue Integrity, revenue cycle functions. Position will serve both our HB Hospital Billing (52 facilities) leaders and PB Professional Billing (>10,000 Providers and 300 Coders) leaders for RIS Rev Cycle Compliance needs for Coding/Billing/Documentation for all of PSJH system wide. Will also partner closely with the RIS Rev Cycle HB Senior Manager, PB Senior Manager, Physician Enterprise Director, Rev Cycle Directors, Billing offices Directors, CFO Managers and other Rev Cycle leaders. Provide virtual and face to face education to caregivers at the Senior Leadership to front line Auditor level staff on tracking and trending both Hospital and Professional coding/billings as compared to an internal benchmark and CMS national averages in a relevant format geared to individual audiences. Provide a strategic and proactive work plan to utilize and maximize risk based soft ware programs to increase efficiencies in assessing, auditing and reporting templates across all of PSJH regions by specialty.

Adhere to compliant billing & coding guidance for both Part A Hospital and Part B Professional regulations. This position is responsible for researching CPT, ICD-10 Medicare, Medicaid and MediCal regulatory billing rules as appropriate.

Directs and supervises the RIS _ Revenue Cycle (RC) Compliance Program Data Analytics Manager and the RIS_Rev Cycle Senior Coordinator Reporting & Reviews. Perform all duties in a manner that promotes team concept and reflects the Sisters of Providence mission and philosophy.

In this position you will have the following responsibilities:

  • Automate and continually monitor the coding and compliance issues of charges/ billings/coding in a retrospective and proactive manner consistent with the RIS RC Compliance program.

  • Responsible for implementation of a comprehensive systemwide compliance plan for revenue cycle interacting with leadership in HIM, Revenue Integrity, revenue cycle functions providing oversight for program that reviews all multi-billion dollar submissions—integral and critical to PSJH mission.

  • Provide oversight for both HB Hospital Billing (52 facilities) leaders and PB Professional Billing (>10,000 Providers and 300 Coders) leaders assuring Compliant Charging/Coding/Billing/Documentation regulations are adhered to for all of PSJH system wide.

  • Partner closely with the RIS Rev Cycle HB Senior Manager, PB Senior Manager, Physician Enterprise Director, Rev Cycle Directors, Billing offices Directors, CFO Managers and other Rev Cycle leaders .

  • Provide Physician, CFO, department Leaders and Auditors training based on individual needs or changes in the guidelines and regulations in person, via lync calls, or emails.

  • Stay abreast of the CPT and ICD - 9/10 Coding guidelines by proactively researching the CPT Coding guidelines.

  • Research and review ICD - 9/10 Coding guidelines and Regulatory billing rules as appropriate.

  • Automate tracking and trending of billing/coding Compliance issues qualified by billing categories and quantified by reimbursement and financial outcomes.

  • Automate both Internal and external reviews while partnering and collaborating with the RIS Rev Cycle Compliance PB & HB Senior Managers and staff.

  • Provide data analytics system wide during the current disaster/pandemic for COVID-19 and future crisis/disaster events as relates to Providence's Fema's applications following the ever changing Federal & State regulations timely and comprehensively.

Qualifications:

Required qualifications for this position include:

  • Bachelor's Degree in Health Care Management, Computer Science or related field

  • 10 years Health Care IT services experience

  • 5 years Management Experience

Preferred qualifications for this position include:

  • Program Management or Educational Leader Certification, upon hire

About the department you will serve.

Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence St. Joseph health from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Non-Clinical Lead/Supervisor/Manager

Location: Washington-Renton

Other Location(s): Oregon-Portland, Washington-Spokane, California-Irvine

Req ID: 261059

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