SUMMARY  

 The position of Health Information Management (HIM) Manager will be a critical role in forming a HIM team and developing the functions that it will be performing across the company and the products it serves. This position requires an extensive understanding of and experience with the medical billing process, coding, document processing, release of information requests, payor compliance and ancillary billing/coding requirements.  

Along with leading their department, the Manager of HIM, Revenue Cycle is responsible for communicating the health of the department to leadership teams via meetings, conference calls, presentations and reports.   

The role also requires strong skills and experience in personnel management, leading and building teams to foster a culture grounded by the core values of integrity, teamwork, innovation, and quality.  

ESSENTIAL DUTIES AND RESPONSIBILITIES (Other duties may be assigned) 

• Provides direct managerial oversight to Health Information Management staff in management of work queues, work processes, and overall work responsibilities.  
• Responsible for the development and execution of all (1) document processing, (2) release of information request and (3) Coding within Exact Sciences and their products.  
• Develops and maintains all HIM department’s priorities, procedures, and policies for Exact Sciences.  
• Determine appropriate and effective performance metrics and staff requirements for the department to run with efficiency and accuracy while providing outstanding customer service.  
• Monitors, DNFC, etc. and ensures RCM is meeting or exceeding internal performance objectives.  
• Ensures that customer satisfaction, via all personnel, is achieved through courteous and effective communication, problem solving and efficient processes.  
• Oversees and manages the daily performance of the HIM revenue cycle department.  
• Motivates team on month end goals and metrics. Reports on month end activity to key leadership.  
• Promotes and demonstrates a team-oriented environment that fosters effective collaboration within and outside of the department.  
• Hires, coaches, inspires and motivates team; Implements and monitors staff productivity and service performance metrics and reports this to leadership.  
• Maintains confidentiality in compliance with HIPAA regulations and ensures that department remains compliant with all relevant regulations.  
• Implements and assists with innovative staff education programs.  
• Apply deep familiarity with payer/insurance appeals and reimbursement processes, experience working in the insurance industry and professional billing.  
• Apply knowledge and familiarization with the Medicare billing regulations, compliance, and reimbursement methodologies especially in the laboratory environment.  
• Apply strong analytical and forecasting skills with demonstrated ability to plan workload, allocate tasks and scale operations to align with business priorities.  
• Manage CDI program and physician education.  
• Oversees and implements staff reporting and building key productivity and accuracy metrics.  
• Apply strong organizational and problem-solving skills.  
• Apply adaptable, open to change and able to work in ambiguous situations and respond to new information and unexpected circumstances.  
• Provides ongoing coaching and development of staff to help them achieve their professional aspirations and meet company employee satisfaction and retention goals.  
• Utilize strong interpersonal and teamwork skills including the ability to easily convey concepts and priorities as well as ability to solicit feedback and inputs.  
• Utilize strong presentation skills with ability to convey information and adjust delivery as appropriate to the audience.  
• Ability to inspire and motivate others and work effectively through influence and collaboration.  
• Support and comply with the company’s Quality Management System policies and procedures.  
• Regular and reliable attendance.  
• Ability to work normal schedule of Monday through Friday during normal business hours.  
• Ability to work in front of a computer screen and/or perform typing for approximately 80% of a typical working day.  
• Coach, Mentor, and Educates by providing timely guidance and feedback to help strengthen the knowledge/skill set of others to accomplish a task or solve a problem.  

NON-ESSENTIAL DUTIES AND RESPONSIBILITIES  

• Additional duties as assigned 

QUALIFICATIONS  

 Education: 

• Bachelor’s degree in healthcare administration, business or related field; or high school degree/general education diploma and 4 years of relevant experience in lieu of degree.  

  Experience:  

• 5+ years of experience working in the medical/healthcare billing area, with strong, demonstrated knowledge of managing claims processing.  
• 3+ years of leadership experience with demonstrated ability to recruit, assess, motivate & inspire others to help business achieve success.  
•  2 + years in HIM related experience leading teams.  
• Automation experience.  
• Experience working in both payer billing and provider billing operations in a Acute care.  
• Membership in any of the patient accounting organizations (i.e., AHAM) preferred.  
• Minimum one (3) year billing experience in a medical facility, ambulatory surgery facility, or acute-care hospital required.  
• 3 years RCM experience in HIM required.  
• 2 years of supervisory/ managerial experience preferred.  

 Skills/Abilities: 

•  Knowledge of CPT, HCPCS, ICD-10 and medical terminology required.  
• CPC, CPM, CPCO, CPMA or similar certification  

PHYSICAL DEMANDS   

While performing the duties of this job, team members are regularly required to sit, stand, walk, reach with hands and arms, and to talk and hear. Team members may be occasionally required to climb or balance, stoop, kneel, or crouch. Team members must occasionally lift, push and/or move up to 30 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. 

Pay Range: $85,500-$98,200 annually 

WORK ENVIRONMENT   

This position is considered remote with possible travel to practice locations in other states. The noise level in the work environment is typical of an office setting.  

The above describes the general content of and requirements for the performance of this position. It is not intended to be an all-inclusive statement of the duties, responsibilities, and requirements of the position.