Johns Hopkins Medicine Laboratory Billing & Compliance Manager in Baltimore, Maryland
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Laboratory Billing & Compliance Manager
Requisition #: 169414
Location: Johns Hopkins Hospital/Johns Hopkins Health System,
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: May 17, 2018
Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.
Reports to the Pathology Information Technology Director or Finance Director, and is responsible for managing, directing, and monitoring of assigned clinical and administrative projects within Pathology including Affiliate Hospitals.
This position is responsible for managing audits of medical/laboratory and related billing/reimbursement records in order to evaluate their accuracy and compliance with Health System policies, government regulations and third party payer contracts. This position in responsible for monitoring Medicare billing edits and identifying trends to determine systemic issues and recommend improvements. This position is responsible for preparing written reports summarizing audit findings and, making recommendations for improvement and correction where identified. Responsible for billing compliance including establishing RPC's and appropriate CPT coding for all ordered and billed tests. The Manager will also be responsible for identifying compliance risk areas and assisting with the development of and implementation of staff training programs and policies where indicated. Assists Pathology Administration in the establishment of goals and objectives, operational policies, and procedures. Analyzes and establishes outside customer accounts and oversees Outreach Clients. Fulfills the needs of customers through Pathology Customer Service or Billing Unit, or other departmental resources.
Provides expert professional and quality assurance for billing and documentation of Pathology services along with the appropriate education of faculty, administration, clinical staff, and billing staff to ensure that revenues are maximized and that all regulatory standards are met. Responsible for assessing fees to apply, client billing, managing payment posting against accounts, creating patient registrations as needed. Handles patient overlay cases for resolution. Responsible for maintaining records to ensure compliance with regulatory standards. Performs other related administrative and professional duties. May require travel to sites throughout the JH enterprise.
Full-time, Day Shift
8:00 a.m. - 4:30 p.m.
Work Location: Johns Hopkins Hospital - Pathology Administration
Pay Grade: MH
Minimum Associates Degree in business, healthcare, laboratory, or other clinical or related field OR 4 years of directly related laboratory, finance, compliance, or QA experience (if counting experience for degree).
A minimum of seven years of progressive financial experience, with four or more years in hospital receivables management experience, and Patient Accounting System(s) within a medical center, university, or health system. (10+ years of related experience; if experience counted towards education). A minimum of four years of directly related experience
Experienced in business office within highly motivated environment.
Experienced in using team building and quality management concepts to positively influence the work environment.
WORKING CONDITION: While performing the duties of this job the employee is regularly required to sit, talk (including prolonged use of the telephone), see and hear. May sit for extended periods at a computer/desk and occasionally required to walk. The employee is frequently required to use hands to type, finger, staple/sort. May reach with hands and arms, stoop, kneel, or crouch. Prolonged vision requirements including viewing computer screen, paper reports/documents, charts and results.
While this position works primarily in an administrative office, there is occasion to enter the clinical laboratory environment. Exposure to toxins and infectious agents exist, but potential for personal injury or harm is minimized if established safety and health precautions are followed. Working in laboratory where there may be discomforts due to odors, noise, temperature fluctuations, and working around lab equipment.
May transport equipment and supplies usually less than 40 pounds from one area to another. In some areas work space is confined, therefore mobility may be difficult.
May be required to provide on-call or emergency support when needed.
"Johns Hopkins Hospital is a Smoke Free Campus"
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.