Revenue Integrity Team Lead

About this role

Department BSD UCP - Vendors - EMR About the Department The University of Chicago biomedical enterprise houses three entities: the Biological Sciences Division (BSD), the University of Chicago Medicine (UCM), and the Pritzker School of Medicine. Collectively called UCM, we are one of the nation's leading academic medical institutions and have been at the forefront of discovery, education, and clinical care since 1927. Located 20 minutes south of downtown Chicago, our Hyde Park main campus provides a single environment for learning, world-renowned basic science and clinical research, and outstanding clinical care.

The BSD is the largest academic unit within the University. The BSD is comprised of faculty from ten basic science departments, 13 clinical departments, and several Centers and Institutes. The approximately 1,300 faculty and 3,000 staff members working in the BSD collaborate across the organization to achieve our Mission, Vision, and Values (MVV):

MISSION: As part of the University of Chicago, we pursue globally impactful solutions to seemingly unsolvable challenges. Through our rigorous research, innovative education, and comprehensive care and healing, we collaborate on life-changing advancements that create meaningful results for our community and the world, including a greater, more equitable future for all.

VISION: Together, we elevate the human experience with knowledge and health care.

VALUES: • Commit to Excellence: We contribute our exceptional talents to all we do and empower the same spirit of excellence in others. • Embrace Curiosity: We stay open to new ideas, champion diverse perspectives, and drive a culture of thoughtful risk-taking to deliver transformative innovation. • Embody Equity: We identify systemic issues and then foster change to drive a more equitable environment inclusive of diverse people, ideas, and fields of science. • Grow Together: We meaningfully collaborate with one another to create something bigger than we could ever achieve alone. • Make a Difference: We lead with heart and compassion in all our interactions. We create positive change in our areas of influence, whether expanding scientific inquiry, developing the next generation of leaders, or healing our community. • Take Ownership: We accomplish what we say we will and hold ourselves and one another accountable for our actions.

The MVV serves as our True North, charting our strategic plan for the next ten years and beyond. It is an exciting time to be a part of the University of Chicago and the BSD. Our team is helping to shape the future for our learners, staff, faculty, patients, and community. Job Summary University of Chicago Physicians Group (UCPG) is seeking a Revenue Integrity Team Lead to assure that UCPG achieves the objective of CMS coding guidelines and adheres to the compliance program of the Medical Center. The Revenue Integrity Team Lead provides support to providers and clinic staff for CPT, ICD-10-CM, and HCPCS coding systems, and acts as a liaison between the off-sites and departments and related educational activities around coding, billing and compliance. This role uses best practices and knowledge related to revenue cycle operations, including activities related to charging, billing, and collecting. Coordinates the management of successful billing and compliance activities with department managerial and executive staff.

The Revenue Integrity Team Lead serves as a key leader within revenue cycle operations, responsible for advancing coding accuracy, documentation integrity, and overall revenue performance. This role provides strategic oversight of coding education, denial management, and revenue integrity initiatives, ensuring alignment with organizational goals, compliance standards, and regulatory requirements.

In addition to education and audit responsibilities, this role will lead and manage coding denial operations, including oversight of offshore vendor teams responsible for daily work queue management. The Team Lead will ensure accurate, timely resolution of coding denials, drive process improvements, and implement strategies to enhance first-pass claim acceptance and maximize reimbursement. The qualified individual will work to achieve overall revenue cycle expectations that comply with larger UCPG organizational goals and Compliance Department expectations, as well as utilize project and people management skills, clinical practice knowledge, and an understanding of documentation and coding requirements to support improvement in practice processes and compliance. Responsibilities • Leads end-to-end management of coding-related denial work queues, ensuring timely and accurate resolution. • Oversees offshore/vendor teams responsible for daily denial work queue execution, including productivity, quality, and performance management. • Performs routine quality assurance (QA) reviews of vendor work to ensure denials are worked accurately, compliantly, and effectively. • Establishes performance metrics, monitor KPIs, and holds vendors accountable for turnaround times, accuracy, and outcomes. • Ensures denial work queues are actively worked daily, maintained at appropriate volumes, and free of aging or inactive accounts. • Develops and implements strategies to reduce coding-related denials and improves first-pass claim acceptance rates. • Identifies opportunities to enhance reimbursement and increase net collections through denial prevention and resolution strategies. • Analyzes denial trends and root causes to drive process improvements and upstream corrections. • Partners with billing, coding, and clinical teams to address systemic issues impacting revenue. • Identifies and executes targeted audit opportunities based on denial trends and risk areas, in addition to other revenue integrity related needs. • Conducts coding and documentation audits with actionable feedback to providers and staff. • Utilizes data analytics tools, including Excel, to track denial patt

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