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CO Sr Production Unit Manager

Job Description

The Pathology Department is seeking a CO Sr. Production Unit Manager who will provide analysis, consultation, and reports to the Department Administrator and the Senior Director of Revenue Operations Physicians Billing Service (PBS). Reviews provider income data with department administration, Clinical Practice Association (CPA) and PBS management. Manages professional fee billing staff to ensure timely and consistent reimbursement for services. Interacts with physicians and their divisional managers to answer related questions and to clarify various billing concerns. Researches and resolves compliance issues. Maintain strict confidentiality of staff and patient information. Will promote teamwork and identify areas of improvement and recommend coordinated actions to bring about changes.

Specific Duties & Responsibilities

Procedural Knowledge

  • Working knowledge of Assistant, Associate and PUM roles and responsibilities.
  • Develop and monitor department group incentive plan targets. Analyze and present data for exceptions, if needed.
  • Provide assistance to the Department Administrator and the Senior Director of Revenue Operations Physicians Billing Service (PBS) in the form of analysis, consultation, planning day-to-day management of the financial and administrative billing operation of the department.
  • Manages professional fee billing staff to ensure timely and consistent reimbursement for services rendered by clinicians from patients, insurance carriers, and/or state and federal agencies as appropriate.
  • Researches and resolves compliance issues and clarifies various billing concerns. Explains monthly service, income and rejection-analysis reports to department physicians, faculty, administration, Clinical Practice Association (CPA) and Physicians Billing Service (PBS) management.
  • Interface with third-party professional relations representatives to include Commercial, HMO, Medicare, Blue Shield and Medicaid. Meets periodically with representatives to discuss payment problems, coding compliance issues, and claim receipts.
  • Act as departmental liaison with payer to stay current with changes in insurance requirements for several hundred payers, assuring that office procedures meet specifications for prompt payment.
  • Monitors charge and revenue budget variances and provides explanation to department Management.
  • Direct the development of billing policies and procedures for the departments' professional fee billing offices consistent with, and complementary to, those already in place with the CPA.
  • Perform yearly reviews of encounter forms.
  • Broad scope of responsibility which includes interactions with physicians, administrators and divisional directors regarding divisional performance.
  • Department has large number of subspecialties requiring expanded knowledge of billing requirements of 3rd party payers.
  • Provide assistance to the Department Administrator and the Senior Director of Revenue Operations Physicians Billing Service (PBS) in the form of analysis, consultation, planning day-to-day management of the financial and administrative billing operation of the department.
  • Manages professional fee billing staff through subordinate managers and supervisors to ensure timely and consistent reimbursement for services rendered by clinicians.
  • Develops and presents divisional monthly report packages to directors and provides in-depth financial analysis at divisional level.
  • Manage large production unit with multiple subspecialties requiring broader scope of specialty knowledge and associated budgets.
  • Oversee and Analyze subspecialty data and routinely interacts with physician divisional directors to review subspecialty billing information used in development of future business strategies.
  • Participate and chair various committees on both a departmental, as well as a school wide level.
  • Monitors essential monthly reports to ensure productivity, unit, core services and CPA objectives are met for their areas of responsibility.


Technical Knowledge

  • Comprehensive knowledge and compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI).
  • Utilize online resources including IDX, Compass and Cognos to facilitate efficient claims processing.
  • Requires a thorough understanding of medical billing and the unique customer service requirements as related to patients, physicians and administrative staff in a high-volume medical services environment.
  • Excellent communication and customer service skills with the ability to work well under pressure.

Professional and Personal Development

  • Participate in on-going educational activities.
  • Assist in the training of staff.
  • Keep current of industry changes by reading assigned material on work related topics.
  • Complete three days of training annually.


Physical Requirements 

  • While performing the duties of this job, the employee may remain in a stationary position (mostly seated) up to 80% of the time. Occasionally required to traverse throughout the work area or to retrieve supplies or mail/documents from other locations. The employee is required to operate computer keyboard, mouse, calculator, and phone 80% of the day; additional duties may require opening envelopes, removing or applying staples, processing mail; requiring finger dexterity and some repetitive motions.
  • Prolonged vision requirements including ability to see/viewing computer screen, paper reports/documents, charts.
  • Position requires frequent use of the telephone, while multi-tasking to retrieve or review information from the computer in order to assist callers quickly and confidentially. Must be able to communicate using the spoken and written word in a clear, concise, and professional manner. Able to hear within normal range.
  • May transport materials usually less than 20 pounds from one area to another; may be required to lift and/or move up to 40 pounds with proper training, or precautions/lifting aides (example: file boxes, copier paper, mail bags). In some areas workspace is confined; may work in an open workstation or cubicle.
  • Staff may be required to complete annual competency review, and must ensure compliance with Hospital Policy, Laboratory Policy & Procedure, Health, Safety & Environment regulations, and all applicable privacy & confidentiality laws/practices.
  • Johns Hopkins School of Medicine -Clinical Operations - Required Attendance position: in the event of unexpected university closings including inclement weather or declared emergency, the employee in this position may be required to report to work and/or remain at work and may be required to work additional hours.


Special Knowledge, Skills & Abilities

  • Strong organizational and analytical skills.
  • Excellent organizational skills.
  • Aptitude for figures and attention to detail.
  • Ability to interact effectively.
  • Capable of meeting deadlines and working well under pressure.
  • Knowledge of PCs and PC applications.
  • Knowledge of JHM and JHU/ PBS billing applications.



Minimum Qualifications
  • Five years progressively responsible professional level experience in a physician’s group practice environment.
  • Three years supervisory experience required.
  • Additional education may substitute for experience, and additional experience may substitute for education to the extent permitted by the JHU equivalency formula.


    Preferred Qualifications

    • In-depth knowledge of academic specific billing issues and management experience in and academic professional fee billing office required.
    • Proficiency in IDX and excellent personal computer skills required.
    • EPIC experience preferred.
    • CPC certification.

     


     

    Classified Title: Sr. Production Unit Manager 
    Job Posting Title (Working Title): CO Sr Production Unit Manager   
    Role/Level/Range: L/04/LD  
    Starting Salary Range: $75,800 - $132,600 Annually ($105,966 targeted; Commensurate with experience) 
    Employee group: Full Time 
    Schedule: Monday-Friday 8:30-5:00 
    Exempt Status: Exempt 
    Location: Hybrid/JH at White Marsh 
    Department name: ​​​​​​​SOM Pat Production Unit Billing  
    Personnel area: School of Medicine 

     

     

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