Manager - Pathology Revenue Regeneration

Henry Ford Health System is seeking a highly motivated and experienced Pathology Revenue Regeneration Manager to lead our newly established Revenue Regeneration team. This role is crucial in enhancing our financial performance by optimizing revenue capture, ensuring compliance with billing and coding standards, and managing cost structures, fee schedules, revenue posting, cash flows, and payor relations within the Pathology department. The work includes both technical and professional component billing.

GENERAL SUMMARY:
Reporting to the Director, Laboratory Operations, responsible for leading the revenue
cycle process including the prioritization of the key areas of activity capture through
collection and reporting for Pathology. Responsible for the management of staff
including hiring, training and performance management. Plays a collaborative role with
the director in terms of communication regarding collection activity, compliance,
physician productivity, process improvement and budget analysis.

PRINCIPAL DUTIES AND RESPONSIBILITIES:
1. Manages the revenue cycle process for the Department of Pathology and Laboratory
Medicine. Accountable for revenue cycle results for Revenue Team across clinical
and anatomic pathology disciplines.
2. Responsible for monitoring activity of the team in line with set financial goals and for
the hiring, training and performance management of the revenue team staff.
Interacts with technical, professional, and information system staff that is part of the
revenue cycle process.
3. Collects and analyzes reports associated with cash collections, charge entry and
missing information. Interacts as needed with third party carriers and internal staff.
4. Provides regular reports to the Director, Laboratory Operations and team on cash
collections, rejections, lost revenue, transaction capture edits, lag time for billing,
and physician productivity.
5. Continually works to improve the efficiency of the billing process, maximize
reimbursement, and makes recommendations for problem solving when appropriate.
Interacts with revenue cycle leaders from other parts of the organization to remain
informed on billing initiatives.

ADDITIONAL DUTIES:

• Lead and manage the Revenue Regeneration team, including hiring, training, and performance evaluation of team members.
• Develop and implement strategies to optimize revenue capture and reduce revenue leakage within the Pathology department.
• Collaborate with clinical, administrative, and financial teams to ensure accurate and timely billing and coding of pathology services.
• Monitor and analyze revenue trends, identify areas for improvement, and implement corrective actions.
• Ensure compliance with all relevant regulations and standards, including Medicare and Medicaid billing requirements.
• Prepare and present regular reports on revenue performance and regeneration efforts to senior management.
• Manage cost structures, fee schedules, revenue posting, and cash flows to ensure financial efficiency.
• Foster strong payor relations to optimize reimbursement processes and resolve any issues promptly.
• Stay updated on industry best practices and changes in billing and coding regulations.

EDUCATION/EXPERIENCE REQUIRED:

• A Bachelor's Degree is preferred; equivalent of 5 years of financial and medical
  experience can be considered in place of the degree.
• Requires experience in medical billing, coding, or the equivalent.
• Working knowledge of coding (CPT & ICD-9) preferred.
• Coding certification needs to be obtained within 2 years of the date of hire. Requires
  2-3 years of supervisory experience.
• Requires work experience that demonstrates leadership ability, initiative,
  assertiveness and previous success in a position of some leadership, either informal
  or formal.
• Computer skills and the ability to access and use data systems.

EXPERIENCE STRONGLY DESIRED:

• Strong knowledge of billing and coding standards, including ICD-10, CPT, and HCPCS codes.
• Proven track record of leading and managing teams to achieve revenue goals.
• Excellent analytical, problem-solving, and communication skills.
• Ability to work collaboratively with cross-functional teams and stakeholders.
• Professional practice management experience preferred, with a strong preference for pathology practice.