Manager PB Coding Denials Integrity - Medical Specialties

Department: 13245 Enterprise Revenue Cycle
- Integrity Operations:
Professional Coding Denials

Status: Full time

Benefits Eligible: Yes

Hours Per Week: 40

• PB Med Specialties:
  Laboratory, Pathology, Behavioral Health, Peds development, Allergy and Immunology, Dermatology, Gastro, Hepatology, Infectious Disease, Endocrinology, Nephrology, Rheumatology, Pulmonology, Sleep, VH, MFM, OB/GYN, OB GYN/Repro Endo, and UROGYN

• Monday
  - Friday 1st shift 40 hours a week.

• Coding Certification issued by one of the following certifying bodies:
  American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA).
• Dual Certification preferred.

Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, , IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY

Pay Range: $51.05 - $76.60

• Operational Leadership:
  Lead and manage daily operations within the assigned function area, ensuring alignment with divisional and enterprise-wide goals.
• Operational Efficiency:
  Evaluate processes to improve efficiency, enhance productivity, and support standardized best practices across the Mid-Revenue Cycle.
• Regulatory Compliance & Confidentiality:
  Ensure adherence to regulatory requirements, accreditation standards, and organizational policies. Maintain confidentiality of patient records and report any perceived non-compliant practices to leadership or the Compliance Department.
• Performance Monitoring & Reporting:
  Utilize key performance indicators (KPIs) to measure effectiveness, track trends, and implement data-driven strategies for improvement.
• Technology Utilization:
  Leverage healthcare technology and analytics tools to enhance efficiency, support decision-making, and drive innovation in Mid-Revenue Cycle processes.
• Collaboration & Stakeholder Engagement:
  Engage with clinical, IT, Compliance, and Revenue Cycle leaders to integrate Mid-Revenue Cycle processes effectively, ensure regulatory compliance, and promote patient safety. Build and maintain relationships with key stakeholders to drive communication, problem-solving, and operational alignment.
• Team Leadership & Development:
  Manage and develop a team of professionals by performing human resource functions such as hiring, performance evaluations, and professional development. Provide training, feedback, and career growth opportunities to foster a high-performing and financially responsible workforce.
• Strategic Initiatives & Execution:
  Lead initiatives to improve operational effectiveness, oversee timelines, and drive system enhancements.

• Relevant industry certification from an approved accrediting body.

• Bachelor’s degree in health information management, Healthcare Administration, or a related field, or equivalent experience.

• Minimum 8 years of experience in mid-revenue cycle operations, coding, HIM, or healthcare technology, including 2+ years of leadership experience in a large integrated healthcare system.

• Mid-Revenue Cycle Expertise:
  Demonstrated knowledge of facility coding, professional coding, and HIM operational guidelines and workflows necessary to scope of work. Understanding of third-party reimbursement programs, state and federal regulatory requirements, national and local coverage decisions, and coding classification systems (ICD-10, CPT, HCPCS).
• Financial & Data Analysis:
  Ability to organize,…