The manager oversees daily managed care operations, including the analysis, negotiation, and maintenance of system-wide agreements. They also facilitate the resolution of contractual issues and provide education to revenue cycle departments regarding contract terms and compliance.
The role involves conducting detailed clinical reviews of medical records to draft effective narratives for Medicare and Medicaid appeals. The incumbent will also assist in research for administrative hearings and collaborate with legal resources to manage regulatory changes.
The Director manages metric reporting, financial planning, and performance monitoring to advance the organization's operational and financial goals. They translate complex business data into actionable insights for leadership while ensuring alignment between strategic objectives and financial forecasts.
This position provides utilization management expertise, program development, and operational support while auditing for compliance with CMS guidelines. The role also acts as a performance improvement coach to enhance staff competency and job performance.
This role involves collecting and analyzing data to provide actionable insights for Revenue Cycle departments. You will collaborate with leadership to develop reporting solutions and identify opportunities for operational improvement.
The incumbent resolves escalated customer inquiries and manages the collection of outstanding guarantor balances for hospitals and physician offices. They also provide financial counseling resources and act as a leader to other team members.
The role involves managing central business office functions including insurance and self-pay follow-up, payment posting, and account adjustments. Additionally, the representative is responsible for monitoring billing errors and providing initial training to staff.
The Coding Supervisor manages the Hospital Coding Operations team and provides daily updates on coding processes and quality initiatives. They ensure compliance with internal policies and assist in developing procedures to facilitate accurate reimbursement.
Responsible for triaging Tier 2 clinical calls and resolving application issues for healthcare staff. Documents all troubleshooting steps and resolutions within the ticketing system while providing just-in-time training for clinical users.
The manager is responsible for leading and developing education and quality assurance programs for the Patient Connection Center. They will coordinate learning strategies, maintain quality policies, and collaborate with leadership to ensure effective execution of training and performance metrics.
Performs cancer registry duties including the completion of abstracts for benign and malignant processes. Ensures all data entry complies with the standards of the Commission on Cancer and the Georgia Cancer Registry.
The Inpatient Coder is responsible for reviewing, analyzing, and coding hospital inpatient medical records. They must accurately select and sequence appropriate ICD-9-CM and ICD-10-CM/PCS diagnosis and procedure codes.
The consultant is responsible for identifying and leading revenue cycle operational effectiveness and performance improvement initiatives. They will scope projects, develop project plans, and create training content to support operational changes.
The Coding Manager oversees the day-to-day operations of the coding department, including managing staff and ensuring accurate reimbursement for hospital services. They are responsible for analyzing coding quality, managing work queues, and ensuring compliance with official coding guidelines.
Review, analyze, and assign accurate ICD-10-CM and CPT-4 HCPCS codes for outpatient medical records. Focus primarily on hospital outpatient surgery, wound care, and observation documentation.
The Application Coordinator is responsible for the design, build, testing, and ongoing support of clinical and revenue cycle applications. They also provide tier III level support and collaborate with interdisciplinary teams to implement system configurations.
Supervises the coding function and staff while overseeing the reimbursement process. Manages auditing, quality control, and ensures compliance with internal and governing agency policies.
Assess physician educational needs regarding coding and documentation to develop and lead training programs. Ensure all coding activities comply with clinical billing standards and government regulations for inpatient and specialty services.
