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Position Classification Description

Position Class Code / Title: B2041 / Medical Practice Specialist
Recruitment Tier: Tier 1
FLSA: Exempt
Grade: 12

This is a description of a Staff Position Classification. It is not an announcement of a position opening. To view descriptions of current openings, please go to UNMJobs and Search Postings to view positions that are currently accepting applications.

The following statements are intended to describe, in broad terms, the general functions and responsibility levels characteristic of positions assigned to this classification. They should not be viewed as an exhaustive list of the specific duties and prerequisites applicable to individual positions that have been so classified.

Summary

Under general supervision, oversees the business activities and systems of the medical practice component of a clinical department within the Health Sciences Center. Advises on and coordinates implementation of policies, protocols, and systems which improve practice productivity, efficiency and customer service and which support the enhancement of revenue. Monitors and oversees compliance with all applicable federal and state laws, regulations, and guidelines dealing with the conduct of a medical practice.

Duties and Responsibilities

  1. Researches and analyzes various medical practice related issues and participates in problem resolution. Advises and assists faculty physicians with strategic billing and documentation issues, to include new or enhanced billing opportunities, which impact positively on the financial well-being of the department.
  2. Comprehensively analyzes the productivity of the practice against established benchmarks and makes recommendations for improvements; analyzes billing practices and current legislation to ensure maximum revenue efficiencies.
  3. Monitors and evaluates the provision of patient services within the practice, to include the appointment system and physician protocols; interacts with and guides clinic managers in the enhancement operating efficiency and improvement of responsiveness to patients.
  4. Oversees and evaluates the department's billing operations to ensure compliance with appropriate procedures and applicable laws, regulations, and policies; trains and updates physicians and staff on proper billing and coding practices, and recommends remedial action as appropriate.
  5. Designs and coordinates the billing processes and systems of the department; participates in the supervision and training of medical coding analysts, and oversees the resolution of billing and coding problems.
  6. Develops and implements operating and compliance policies, procedures, and reporting systems; prepares and distributes periodic and ad hoc reports on practice and compliance issues and performance indicators.
  7. Reviews and evaluates department interaction with external physicians, and designs and implements systems and procedures to improve communications and to provide feedback to referring physicians.
  8. Analyzes current and potential markets for patient services and identifies areas of potential growth for the practice.
  9. Performs miscellaneous job-related duties as assigned.

Minimum Job Requirements

  • High school diploma or GED; at least 7 of experience directly related to the duties and responsibilities specified.
  • Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis.

Knowledge, Skills and Abilities Required

  • Skill in examining and re-engineering operations and procedures, formulating policy, and developing and implementing new strategies and procedures.
  • Knowledge of physician referral protocols and conventions.
  • Knowledge of clinical productivity standards and benchmarks.
  • Knowledge of laws, regulations, methods in area of specialty.
  • Skill in the analysis and evaluation of clinical appointment systems and physician protocols.
  • Ability to gather data, compile information, and prepare reports.
  • Ability to perform research and to identify potential areas of business opportunity.
  • Knowledge and understanding of the operating characteristics and procedures of a medical practice.
  • Ability to make administrative and procedural decisions and judgments on sensitive, confidential issues.
  • Working knowledge and strategic understanding of medical billing and reimbursement principles, procedures, and documentation.
  • Knowledge of current legislation and developing legal issues and trends in medical billing, coding, and associated documentation.
  • Ability to communicate and interact effectively with practicing physicians and clinical management.
  • Ability to supervise and train employees, to include organizing, prioritizing, and scheduling work assignments.

Distinguishing Characteristics

    Position requires: a) providing expertise in the design, implementation, and analysis of procedures and protocols within a complex clinical department; b) compilation of financial and operating analysis; c) business and operational planning for revenue-generating operations of a clinical department.

Working Conditions and Physical Effort

  • No or very limited physical effort required.
  • No or very limited exposure to physical risk.
  • Work is normally performed in a typical interior/office work environment.

The University of New Mexico provides all training required by OSHA to ensure employee safety.

Revised Date: 06/27/2017