Revenue Integrity & Epic WQ Supervisor - Carle Health : Job Details

Overview The Supervisor, Revenue Integrity & Epic WQ Support is part of the Revenue Integrity team within the Financial Operations Department and reports to the Manager, Revenue Integrity. The Supervisor oversees the analytical staff within the Revenue Integrity team and supports enterprise standardized charge capture focused on WQ throughput. The position will reviews and implement workflows and processes to reduce missed or delayed charges, monitor and assists WQ owning departments to appropriately and timely clear edits in WQs, assess charge and billing errors for system improvement, and identify new revenue opportunities. This role is also responsible for assisting with training revenue generating departments as it relates to accurate and timely charge capture and management of Epic WQs. In collaboration with the manager, supports CDM oversight for accurate and complete content to support the overall system. In collaboration with manager, is responsible for interviewing, hiring and terminating staff. Accountable for personnel related duties that include job performance evaluations, disciplinary actions, payroll reporting, productivity reporting, quality assurance, continuing education, overall job performance and enforcing required rules and regulations. Assists management to ensure established budgetary goals are met. Qualifications Serves as the primary liaison to monitor Epic WQ ownership and functionality across the system, supporting WQ owning areas in ensuring edits are resolved timely Coordinates between WQ owning areas and Revenue Cycle Systems teams to support resolution to system issues in WQ edits and structure. Facilitates monitoring and tracking of charge lag, operational department charge reconciliation, and Epic WQ health across the system. Supports monitoring of new department or service implementations and ensures accurate revenue capture is achieved post go live. Oversees analytical team in tracking coding and regulatory updates to ensure system wide implementation of accurate and full charge capture and system CDM structure balancing CMS regulations, AMA CPT guidelines, and third party payor policies. Maintains ongoing knowledge of all job functions performed in the areas being supervised as well as maintains a thorough working knowledge of all the systems utilized to perform the work in the areas being supervised. Creates and manages staff schedules, completes timecard review and approval and manages paid leave requests from staff. Recommends or initiates personnel actions for hires, promotions, transfers, discharges, and disciplinary measures. Initiates and completes staff performance evaluations and annual reviews. Ensures staff members are adequately trained and are competent to perform all required job tasks. Participates in appropriate continuing education or certification activities. Conducts regularly scheduled meetings with staff, facilitates and collaborates on initiatives within the department, enterprise wide, and with external entities. In addition, assists employees in solving work related matters. Acts as a resource and mentor to others. Endorses and performs all required tasks associated with the Carle Experience such as, but not limited to, regular rounding with staff and completion of all reports to have meaningful and productive monthly meetings with the manager. Responsibilities EDUCATIONAL REQUIREMENTS Bachelor's Degree in Healthcare or Finance related field. or Experience in Lieu of Education - Three (3) years of experience in Healthcare Revenue Integrity may be considered in lieu of a bachelors degree. EXPERIENCE REQUIREMENTS Three (3) years experience in healthcare revenue cycle operations. (This experience level is in addition to the three (3) years of experience for consideration in lieu of degree). Strong experience in application of CMS regulations, CPT, HCPCS, modifier, UB04, 837P, revenue code, and GL structure. Extensive knowledge of revenue cycle processes and medical billing. Extensive working knowledge of reimbursement methodologies. Working knowledge of insurance terms and remittance codes.preferrederred experience in Epic Resolute PB and HB, WQ, dashboards, and reports within the Epic platform. Provider Based, RHC, and CAH Method II billing a plus. ADDITIONAL REQUIREMENTS Carle Leadership Academy certification and remote training Epic readiness classes. Coding Certifications such as CPC, CCA, CCS, RHIA, RHIT, CRCR, CRIP,CHRI or equivalent highly desirable. Ongoing remote Epic training may be required as defined by user role. About Us Find it here. Discover the job, the career, the purpose you were meant for. The supportive and inclusive team where you can thrive. The place where growth meets balance - and opportunities meet flexibility. Find it all at Carle Health. Based in Urbana, IL, Carle Health is a healthcare system with nearly 16,600 team members in its eight hospitals, physician groups and a variety of healthcare businesses. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet designations, the nation's highest honor for nursing care. The system includes Methodist College and Carle Illinois College of Medicine, the world's first engineering-based medical school, and Health Alliance. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: [email protected].