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About the Role

Supports the VP of Revenue Cycle Operations and Optimization in managing revenue cycle optimization, including third-party vendor relationships, identifying optimization strategies, regulatory compliance, and system maintenance. Collaborates on fee schedules, contracts, and credentialing for managed care. Leads strategic initiatives to improve financial performance, operational efficiency, and compliance. Works with stakeholders to strengthen revenue integrity, reporting, reimbursement accuracy, and overall performance.

Responsibilities

Recruits, retains, and develops staff, providing performance feedback and maintaining a professional work environment.
Evaluates staff performance, completes evaluations, sets goals, and manages corrective actions.
Partners with Human Resources and Revenue Cycle leadership on recruitment, onboarding, succession planning, employee engagement, and staff retention.
Performs other leadership, training, mentoring, and operational support responsibilities.
Promotes accountability, continuous improvement, operational excellence, and a culture of collaboration.
Analyzes revenue cycle trends to identify opportunities for denial prevention, reimbursement optimization, first-pass claim acceptance, and cash collection maximization.
Performs root cause analysis of revenue cycle issues, develops corrective action plans, and implements process improvements.
Develops, executes, and manages work plans, including billing corrections, reimbursement optimization, appeals, and workflow improvements.
Collaborates with the Epic managed services organization and Information Technology to implement automation and system enhancements.
Collaborates with third-party RCM vendors to implement process changes.
Ensures alignment between clinical operations, revenue cycle workflows, payer requirements, and billing practices.
Tracks adherence to implemented process changes, measures key performance indicators, and quantifies financial outcomes.
Monitors and reports key revenue cycle performance indicators including cash collections, days in accounts receivable, denial rates, clean claim rates, charge lag, timely filing, and underpayment recovery.
Monitors Health Centers’ adherence to charge reconciliation processes and key performance indicators, partnering with Health Center leadership.
Ensures changes within the charge description master (CDM) coincide with and are implemented within clinical systems.
Reviews changes in CPT®, HCPCS, and revenue codes for accuracy, compliance, and reimbursement optimization.
Identifies opportunities to automate manual revenue cycle processes through Epic optimization, workflow redesign, reporting enhancements, and collaboration with IT and vendors.
Provides guidance to the Senior Data Analyst in the development and implementation of reporting tools to identify revenue cycle trends.
Supervises the building of reporting tools to monitor productivity and quality of work performed by staff impacting RCM results.
Works closely with Data Analytics team to develop dashboards, scorecards, and other performance monitoring tools.
Develops and delivers training, or partners with appropriate departments, on revenue cycle processes, system enhancements, regulatory requirements, and operational best practices.
Maintains up-to-date knowledge of CMS billing rules and payer requirements.
Remains current on Epic reporting tools.

Requirements

Minimum of an associate degree in business administration, accounting, healthcare administration, or other related degree.
Minimum 5 years of experience related to billing, coding, denial management and underpayment analysis.
Demonstrated leadership skills.
Two years’ experience with EPIC Reporting (slicer/dicer or clarity).
Proficient with Microsoft Office Suite; Advanced Excel skills including Pivot Tables and V Look Ups.
Deep understanding of EMR systems; Experience in an EPIC environment.
Strong data management and data analysis skills; research oriented with the ability to critically analyze large data sets.
In-depth knowledge of Medicare/Medicaid regulations, including billing, coding, and documentation requirements.
Strong experience in revenue cycle management and optimization.
Experience with principles of process improvement.
Excellent organizational skills.
Ability to produce high-quality work in a fast-paced environment with changing and/or competing priorities.
Ability to exercise sound judgment and independent decision-making skills.
Ability to produce reliable, high-quality work with minimal direct supervision.
Ability to exercise discretion in the handling of confidential information.
Possess strong work ethic.
Ability to remain focused and calm in stressful situations.
Excellent interpersonal, written and verbal skills.
Ability to develop and maintain effective, professional relationships with internal and external stakeholders.
A demonstrated commitment to PPGNY’s mission related to bodily autonomy, health equity, gender and racial justice.
A demonstrated commitment to learning about and enhancing practices related to racial equity and its impact on healthcare systems.
Strong relationship building and communication skills, including an ability to work and build trust across cultural differences.
Ability to mentor a culturally diverse team, including creating and sustaining an organizational culture that fosters inclusiveness and equity.
Strong knowledge of data and analytics to ensure good decision making, performance measurement and financial analysis.
Ability to work collaboratively in cross-organization workgroups.
Customer service and interpersonal skills and the ability to coordinate work with others, both internally and externally, to accomplish tasks.
Engages in mutual problem solving.
Facilitates continuous process improvements.
Strong time management skills, including ability to work in a high distraction environment and to juggle multiple deliverables at one time.
Strong project management skills, identifying all steps required to meet deliverables, working with key stakeholders, in order to achieve goals, and barriers to success.

Skills

EPIC Reporting
Microsoft Office Suite
Advanced Excel skills
EMR systems
EPIC environment
Data management
Data analysis
Medicare/Medicaid regulations
Revenue cycle management
Process improvement
Project management
Time management
Interpersonal skills
Written communication
Verbal communication
Relationship building

Location

New York

Work Type

Full-time
Office environment
Potential exposure to communicable diseases
Requires flexible schedule
Work in excess of 7.5 hours per day and/or 37.5 hours per week during peak periods

Experience Level

Minimum 5 years of experience
Two years’ experience with EPIC Reporting

Education Level

Associate degree in business administration, accounting, healthcare administration, or other related degree
Bachelor Degree (Preferred)
Coding certification (e.g. CCS, RHIA, RHIT) or applicable experience (Preferred)
EPIC related certifications (Preferred)

Benefits

Generous PTO and holiday schedule
Medical, dental and vision coverage options for you and eligible dependents
FSA, HSA, Commuter pre-tax reimbursement funds
Short- and Long-Term Disability, Free Basic Life and AD&D
401(k) Retirement Plan with Safe Harbor contributions after 1 year of employment
Proof of immunization or immunity to certain communicable diseases (including influenza during the flu season and Covid-19) and testing for tuberculosis.

About the Company

Planned Parenthood of Greater New York (PPGNY) is a leading provider, educator, and advocate of sexual and reproductive health care in New York State.
PPGNY provides a wide-range of family planning services at its brick-and-mortar health centers and mobile care units.
PPGNY cares for everyone regardless of their immigration status, zip code or ability to pay.
PPGNY’s education and outreach programs are backed by medically accurate, evidence-based information.
As a voice for reproductive freedom, PPGNY supports legislation and policies that ensure all New Yorkers have access to the full range of reproductive health care and education.
At PPGNY, we provide the absolute best care to our patients and our communities through innovative health care delivery and education programming.
PPGNY fiercely advocates for policies to ensure that all New Yorkers will have access to the full range of reproductive health care services and information.
PPGNY is committed to diversity, equity, and inclusion.
We believe we are most impactful when people with a wide range of backgrounds, experiences, and identities come together with common purpose.
We encourage candidates from all backgrounds to apply.

Equal Opportunity

PPGNY is committed to diversity, equity, and inclusion.
We believe we are most impactful when people with a wide range of backgrounds, experiences, and identities come together with common purpose.
We encourage candidates from all backgrounds to apply.