Position Overview:

The UCM Revenue Integrity and Compliance Coordinator will be a dynamic and self-motivated individual able to provide revenue cycle support to Upstate Community Medical (UCM). In addition, the Revenue Integrity and Compliance Coordinator will also support other members of the UCM leadership team and participate in the organization and execution of activities with other UCM operations staff.

The Revenue Integrity and Compliance Coordinator under the direction of Executive Director will independently perform multiple revenue cycle and compliance job duties that require a broad range of skills and knowledge that is highly regulated. The position requires a professional demeanor, the ability to prioritize multiple activities while maintaining a confidential environment. Excellent communication, interpersonal and collaboration skills are essential for this role due to interactions with providers and senior members of the organization as well important external stakeholders.

Tasks, Responsibilities and Essential Functions:

• Provide high-level, confidential support to UCM Executive Director and leadership team.
• Provide revenue cycle support for professional billing, coding and compliance.
• Work in collaboration and coordination with Clinical Leadership, Executive Director and leadership team to draft and distribute communications on behalf of UCM to internal and external teams.
• Build a strong working relationship with the UCM team by organizing efficient communication and following up with deadlines and pertinent information.
• Provides support to UCM hiring manager in the credentialing and enrollment of providers and staff.
• Assist in the preparation of business and operating materials and other key presentations for internal and external UCM leadership meetings.
• Assist in the development and maintenance of UCM document and knowledge repositories, websites, and business systems.
• Serves as coding resource for all specialties within UCM practice
• Provides training and education on all new CPT codes and existing codes
• Performs charge capture reviews and supports departments in identifying charging opportunities.
• Responsible in conjunction with the Executive Director compliance plans and reviews
• Monitor compliance with corporate, Federal, and State guidelines bring forward changes, as applicable, while focusing on accuracy and revenue cycle integrity.
• Performs pre-bill reviews for coding quality and accuracy for each specialty UCM supports and provides education either one-on-one or group setting. This would include review of provider documentation and charge documents.
• Monitors professional charging processes and systems with in-depth knowledge of inpatient and ambulatory charging.
• Support Executive Director in payer contract reviews including rates and fee schedules. Support with negotiations and analysis.
• Ability to understand and analyze payer regulations and impact to the professional chargemaster on reimbursement and coding guidelines
• Coordinates with Upstate University Hospital’s IT department to order and maintain computers and printers for all UCM departments. Creates, tracks, and maintains all purchase orders for computers and other IT equipment.
• Conducts internal reviews to improve revenue cycle, claims production and coding integrity
• Demonstrated continuing self-development initiatives, meets established goals and objectives in a timely fashion, participates in developmental opportunities that enhance job performance.

Qualifications:

• Associates Degree required.
• A minimum of five (5) years related experience in revenue cycle, billing, coding, and compliance
• Certified Professional Coder or equivalent
• Epic knowledge preferred
• Revenue Cycle Compliance preferred
• Professional billing knowledge preferred

Licenses:

• Certified Professional Coder (CPC)
  • Obstetrics and Gynecology experience preferred
• Obtain CPC Certification within one year if not currently certified

Knowledge and Skills:

• Knowledge of office management systems and procedures.
• Proficiency in MS Office (Excel, Word, Outlook, and PowerPoint)
• Knowledge of clinical settings such as inpatient and ambulatory clinics
• Ability to research coding and regulatory requirements
• Strong analytical skills
• Excellent judgement, discretion, initiative, and ability to maintain strict confidentiality
  and high ethical standards
• Ability to work independently and balance competing priorities and tight deadlines
• Attention to detail and problem-solving skills
• Excellent time management skills and the ability to prioritize work
• Excellent written and verbal communication skills
• Strong organizational skills with ability to multi-task
• Knowledge of billing, coding, and regulatory compliance

Job Related Physical Abilities:

Must be able to sit for long periods of time, bend, stand, stoop, and perform repetitive motions for use of computers and office equipment. Able to speak and hear sufficient to communication with internal and external customers. Ability to view a computer monitor/screen and enter data. Ability to lift approximately 20 lbs.