Vice President, Billing Compliance and Review

Responsibilities:

• Patient/Customer
• Deliver financial processes and systems which support Penn Medicine goals.
• Develop customer service orientation of Billing Compliance to all constituencies.
• Develop customer service orientation of government audits and appeals supporting all entities of Penn Medicine constituencies to include oversite of software to efficiently manage audit activity.
• Regular communication with UPHS leadership to ensure client needs are being met.
• Annual presentation to the Penn Medicine Audit and Compliance Committee
• Chair Penn Medicine Billing Compliance Oversight and Recovery Audit Committee’s conducted quarterly.
• Actively participate in Hospital Utilization Review committees as needed.
• Ensure leadership is informed of any material compliance concerns.
• UPHS Financial Strategies & Policies
• Provide project management leadership for the development and implementation of common financial systems and standards in a coordinated and efficient manner. Identify and facilitate department, entity and system improvement opportunities.
• Participate, support and provide compliance guidance to UPHS leadership regarding matters of compliance. Where needed, monitor progress of goal attainment and provide direction and guidance.
• Participate in the establishment of organizational goals to best support the overall mission of Penn Medicine.
• Participate in negotiation with vendors on behalf of the Office of Billing Compliance and work with Office of the General Counsel to review contracts with focus on compliance matters.
• UPHS Billing Compliance
• Ensure UPHS fully utilizes appropriate financial controls and maintains compliance with Federal & State regulations and documentation requirements.
• Responsible for work activities for the Office of Billing Compliance to ensure proper completion of audits in a timely manner to include planning, coordinating, and managing compliance reviews.
• Provide leadership and guidance for Billing Compliance integrated compliance plan to include professional fee and hospital services.
• Ensure the Audit function of the department operates efficiently and effectively in all aspects of responsibilities.
• Ensure mandatory compliance education program are effective to include monitoring and reporting on compliance with the education standard to leadership.
• Oversee compliance information and reporting lines to include maintenance of activity logs, notification of pertinent issues to the UPHS leadership and the Office of the General Counsel prompt investigate reported issues while ensuring confidentiality and appropriate resolutions to all issues.
• Oversee and coordinate external government audits and appeals to include software applications and communication with key stakeholders.
• Represent Penn Medicine with respect to government audits and appeals to include attendance at opening and closing conferences.
• Staff Development
• Recruit and retain talented results-oriented team.
• Develop and maintain effective succession and contingency plans to ensure continued operations.
• Mutually develop and implement learning and development plans for direct reports.
• Ensure finance leadership team proactively engages in good management techniques such as people management, performance management and appropriate rewards and recognition programs.
• Establish and ensure effective and ongoing communication vehicles. Ensure regular meetings within respective areas.
• Encourage and support professional staff development.
• Maintain high standards of professional conduct at all times. Represent the Office of Billing Compliance at events.
• Ensure the provision of high-quality services by maintaining staffing resources for each project that is consistent with the unit's workload and budget/productivity indicators. Responsible for all collective efforts of all direct reports.
• Ensure that clear channels of communication, delegation and accountability within the units of effective supervision and problem solving. Provide opportunities of continuing education, skill training and upward mobility for employees and create an environment that encourages productivity, loyalty, job satisfaction and positive reinforcement. Mentors staff to accomplish individual goals.
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.
• Other duties as assigned to support the unit, department, entity, and health system organization.

Education/Experience:

• Master's Degree in Accounting, Finance, Business Administration, Health Administration or related field (Required)
• 7+ years of experience in healthcare, business or accounting, preferably in a physician practice and/or hospital environment (Required)
• 5+ years of progressive managerial experience. Knowledge of compliance regulations, automated billing systems, and third-party billing to include technical and professional fee reimbursement methodologies (Required)

Skills & Abilities:

• Demonstrated interpersonal/verbal communication skills
• High level of initiative in achieving consistency between practice operations.
• Routinely utilizes judgement in dealing with department chair's, University of Pennsylvania Health System Administrators, Office of Legal Counsel, and external contacts.
• Must be creative in handling difficult and sensitive accounting and operational problems.