Supervisor, Revenue Cycle Audits & Clinical Denials

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 The University of Miami/UHealth Central Business Office has an exciting opportunity for a full-time Supervisor Revenue Cycle Audits/CDU to work in Miami, FL. The Supervisor Revenue Cycle Audits and Clinical Denials leads, trains, and monitors the team that conducts reviews of External Audits and denials related to billing, coding, and medical necessity from governmental and commercial payers. The Supervisor Revenue Cycle Audits/ CDU contributes to the success of the Revenue Cycle and Compliance program by serving as an expert on coding, billing, federal and commercial guidelines.  In addition to analyzing, reviewing, and responding to requests from external auditors to maximize collections.

CORE JOB FUNCTIONS                                                                                                          

• Supervises, facilitates training, and prepares performance reports of the results of external audits and clinical appeals.

• Advise Revenue Cycle Management regarding Third Party Payer trends, audit activities and denials patterns.

• Maintain knowledge concerning updates of local and federal coding and billing compliance regulations.

• Serves as primary UHealth liaison for governmental and commercial payer external audits. 

• Reviews and analyzes documentation to support acceptable billing and documentation practices.

• Reviews, organizes, and distributes incoming third-party payor audit correspondence establishing strategies and priorities.

• Prepares logs and statistical reports of review findings and appropriately disseminates information.

• Gives technical and educational assistance to the staff members of the Revenue Cycle Audits and Clinical Denial Unit teams.

• Maintains active surveillance of productivity and work quality results for all the staff members under his/ her Supervision. 

• Establishes and continuously assesses the effectiveness of the internal controls within the unit and compliance with the University of Miami and Revenue Cycle policies and procedures.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

CORE QUALIFICATIONS                                                                                                  

• Bachelor’s Degree in relevant field or equivalence.

• Certification in Medical Coding (CHC, CPC, CCS, CPMA, RHIT, RHIA) through AHIMA or AAPC

• Minimum 5 years of relevant experience.

• Strong clinical and medical terminology knowledge.

• Ability to maintain effective interpersonal relationships

• Ability to communicate effectively in both oral and written form.

• Ability to effectively plan, delegate and/or supervise the work of others. Ability to lead, motivate, develop and train others.

• Ability to establish department goals and objectives that support the strategic plan.

• Skill in collecting, organizing and analyzing data.

• Proficiency in computer software (i.e. Microsoft Office)

• Ability to work independently and/or in a collaborative environment

Any relevant education, certifications and/or work experience may be considered.

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The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.

Job Status:

Full time

Employee Type:

Staff