DEVELOPS & IMPLEMENTS BILLING GUIDELINES & POLICIES: Assists with the formulation and implementation of department policy and changes in procedure pursuant to changes in health care reimbursement. Develops targets for revenue, write offs, collection referrals and action plans to meet goals. Identifies problems and develops action plans to resolve. Presents findings and recommendations to department senior management. Oversees billing and collection operations producing third party and patient receipts of 21 million annually. Plans, directs and evaluates the collection activities of 25 physicians. Develops strategies to improve overall performance in cash collection, days in accounts receivable and net collection rates. Manages adjustments, write offs, and courtesies.
SUPERVISES BILLING STAFF OF 11: Hires, makes salary recommendations, and oversees training in procedures and coordination of training sessions provided by Physician Organization Billing Office. Assigns duties, conducts performance appraisals. Assists in the development of productivity standards and ensures staff are meeting those standards. Develops corrective action plans for staff not meeting the standards. Measures the effectiveness of physician education and financial activity using PO and outside benchmarks.
COMPLIANCE: Adheres to compliance plan of WCM by enhancing education of staff and oversees medical record reviews with departmental Compliance Liaison, oversees establishment and implementation of correction action plans in conjunction with department's Physician Compliance Leader.
COLLECTION: Manages in-house and outside collection operations. Determines accounts to be written off or referred to outside collection agencies following exhaustion of internal efforts. Monitors external agency efficacy and makes recommendations of future affiliations. Authorizes payment of collection agency commissions.
ANALYZES DATA TO ENHANCE REVENUE OPPORTUNITIES: Utilizes Epic, Eclipsys/Allscripts, Cognos applications and tools to maximize revenue and increase operational efficiencies. Utilizes financial reports to develop action plans aimed at maintaining or improving financial and/or operational performance. These include but are not limited to edit lists, rejection sub-system, Paperless Collection System (PCS), mission charge report and internet or NYPH system products for claims verification and eligibility, electronic claims and payment remittances, dunning tables, form letters, dictionaries and Data Base Management (DBM) Report Writer.
DEPT RESOURCE FOR WCM PHYSICIAN ORGANIZATION PRACTICES: Serves as resource to faculty and support staff regarding PO practices. Analyzes practices, recommends modifications of practice, evaluates code usage and linkage of codes and procedures to ensure maximum reimbursement. Acts as a liaison with PO Business Office regarding all accounts receivable and practice management activity for the department.
Creates and utilizes financial spreadsheets, Epic & Cognos standard and customized reports to analyze accounts receivable and ensure financial and operational targets are met. Establishes operational benchmarks, metrics and productivity standards to streamline workflows and identify improvement opportunities.
Communicates and develops relationships with payers to resolve problems. Keeps abreast of changes in industry and governmental regulations that impact physician billing and reimbursement. Attends workshops, seminars and/or conferences to keep abreast of standards and best practices within the field. Disseminates information to colleagues and/or staff as appropriate.
Attends Physician Organization and WMC IPA meetings and training sessions; recommends proposed participation in HMOs and coordinates physician credentialing.
Advise faculty & support staff regarding billing practices, coding and strategy to optimize the revenue cycle. As needed, assists with the development and implementation of revenue cycle strategies and workflows that will enhance cash collections, expedite account resolution and streamline billing processes.
Reviews, updates and maintains fee schedules and procedure code dictionaries. Develops, writes and distributes changes to WCM’s coding rules when needed. Develops, implements and manages quality control and audit procedures to monitor the timeliness and effectiveness of revenue cycle activities.
Performs other job-related duties as required.
Approximately 7-10 years of related supervisory experience
College degree in related field
Knowledge of medical terminology, ICD-10 and CPT-4 coding
Minimum one year supervisory and five years’ general physician billing and collection experience in academic medical center
Experience with spreadsheets and word processing software applications (MS Office)
About Weill Cornell Medicine, Department of Urology
Weill Cornell Medicine (WCM), Cornell University's medical school located in New York City, is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine, locally, nationally and globally. Physicians and scientists of Weill Cornell Medicine are engaged in cutting-edge research from bench to bedside, aimed at unlocking mysteries of the human b...ody in health and sickness and toward developing new treatments and prevention strategies. In its commitment to global health and education, Weill Cornell has a strong presence in places such as Qatar, Tanzania, Haiti, Brazil, Austria and Turkey. Through the historic Weill Cornell Medical College in Qatar, WCM is the first in the U.S. to offer its M.D. degree overseas. Weill Cornell is the birthplace of many medical advances — including the development of the Pap test for cervical cancer, the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial of gene therapy for Parkinson's disease, and most recently, the world's first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. Weill Cornell Medicine is affiliated with NewYork-Presbyterian Hospital, where its faculty provides comprehensive patient care at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. WCM is also affiliated with the Methodist Hospital in Houston. For more information, visit www.med.cornell.edu.
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