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Planned Parenthood of Illinois · 4 months ago

Manager of Billing and Credentialing

Chicago, IL

Full-time

Hybrid

Mid, Senior Level

$75K/yr - $75K/yr

5+ years exp

Planned Parenthood of Illinois is seeking a Manager of Billing and Credentialing responsible for overseeing health center billing and provider credentialing. This role ensures compliance with billing regulations and supervises multiple teams to optimize revenue cycle processes.

Hospital & Health Care

Responsibilities

Supervises the Contracts and Credentialing Team and ensures accuracy by applying consistent technical knowledge and follow up in daily workflow processes

Supervises the Billing/Revenue Integrity Team and ensures that all services that are received are reimbursed

Serves as Revenue Cycle Management (RCM) Liaison with PPIL Vendors to resolve Billing and Credentialing scopes through timely follow up

Ensures that all Health Center services are charged and that all Pre-Bill errors are resolved daily in the Epic Workques

Ensures that accurate notes and complete follow up statuses are listed on patient accounts

Ensures the maintenance and updating of the PPIL Fee schedules

Ensures the maintenance and updating of the PPIL Charge master pricing and Coding by applying consistent technical knowledge and follow up

Ensures Team compliance with State, Federal and payer rules to prevent external audits and revenue loss

Ensures timely processing and resolution of Contact Center, Vendor and patient request

Ensures up to date documentation is maintained in the patient accounting system to meet quality assurance and productivity standards

Serves as the Internal Project Manager for Revenue Cycle Audits and Coding Training

Assist as an RCM Payer Relations “problem solver” on all denials/revenue loss related task and ensures follow up

Proactively Ensures Team PPFA Financial performance metrics are met by running EPIC BI report and monitoring Epic dashboards to ensure team guidance to prevent revenue loss

Proactively stays up to date on Revenue Cycle standards, Coding and Credentialing through self- initiated professional development to ensure accountability in performance of the duties of the role

Supports and Implements the Directives of the Director of Payer Relations and Revenue Cycle Management to ensure team compliance with Department Policies and Procedures

Coordinates with Health Center staff to ensure that all clinical documents in the EHR are received and encounters are closed daily with reconciliation

Maintain a professional and collaborative relationship with all teammates and vendors to resolve issues, increase knowledge of insurance requirements, and create standardized workflows

Facilitate training and onboarding of new teammates as well as ongoing training and education for established team members throughout the State of Illinois

Through these activities demonstrate an understanding of and commitment to PPIL core values of access, activism, care, confidentiality, diversity, excellence, integrity, respect, self-determination, and stewardship; practice these values in relations with internal and external customers

Perform other duties as assigned

Qualification

Healthcare BillingRevenue Cycle ManagementEpic WorkquesBilling ComplianceContracts ManagementCoding CertificationSpreadsheet SoftwareInterpersonal SkillsAttention to DetailCommunication SkillsLeadership Skills

Required

High School Diploma or GED required

Certification in Billing and or Coding is required

Strong knowledge of Self-Pay, Commercial, Medicaid/MCO Insurances Billing and Collections

Minimum of 5 years of relevant Healthcare Billing, Contracts Management and/or Charge master (CDM) experience required

Ability to demonstrate working knowledge of health care Billing and denials processes, including a thorough understanding of medical insurance carrier policies and procedures, State and Federal rules and regulations

Technology skills must include experience in the use of spreadsheet software (Excel) and the resolution of Billing Workques in the electronic records systems (EPIC) required

Excellent follow-through and attention to detail

Ability to lead by example and inspire others to perform at their highest level

Ability to proactively prioritize and attend to detail

Excellent interpersonal relationship management skills

Leads with Integrity and Accountability

Strong communication, written and oral, and excellent organizational skills

Ability to work under pressure and meet stringent deadlines, in a fast-paced environment with professionalism

Commitment to maintaining confidential information

Ability to think as well as act flexibly and creatively in a fast-paced environment

The position will be a hybrid model of remote work and on-site weekly. This position requires traveling to various Health Centers statewide periodically therefore a personal vehicle, a valid Illinois driver's license, and auto insurance in accordance with agency liability standards is required

The Manager must demonstrate a commitment to the mission and operating goals of Planned Parenthood of Illinois