Manager, Revenue Integrity

Role Overview

• Optimize workflows and related information systems to ensure accurate, complete, timely documentation, charges and coding of services
• Maintain extensive knowledge of all aspects of the revenue cycle including registration, documentation, coding, billing and collection processes
• Analyze and assess diverse data relating to the revenue cycle
• Provide essential quality reports and improvement recommendations to management for all clinical service lines and revenue cycle departments

Requirements

• Bachelor’s degree in Healthcare related field, Master’s Degree Preferred
• Associate’s degree with 10+ years’ experience directly related to healthcare and Revenue Integrity in lieu of a Bachelor’s degree
• Seven years minimum recent and direct related experience
• Previous management experience in Clinical service area(s), Revenue Integrity, Revenue Cycle Area(s)
• Strongly Preferred: Previous clinical experience
• Active Certified Coding Specialist (CCS) and/or Certified Professional Coder and/or Certified Outpatient Coder and/or Hospital (CPC-H) (or attainment within one (1) year of hire)
• Preferred: Dual Certifications i.e., CPC and CCS
• Extensive clinical coding knowledge; clinical experience preferred
• Solid understanding of the reimbursement systems including IPPS, OPPS, DRG, etc.
• State and federal and third party payer regulations
• CPT/HCPCS/ ICD classification, medical terminology, billing and reimbursement processes
• Extensive knowledge of charge creation, processing and reconciliation in a health care environment
• Strong quantitative, analytic, and problem-solving skills
• Strong organizational skills
• Strong time management, attention to detail, and follow through
• Excellent interpersonal and communication skills
• Microsoft Office, Outlook, Excel; Epic experience highly desirable
• Well developed, formal presentation skills
• Ability to effectively collaborate with providers and staff at all levels
• Manage day to day operations managing staff and ensuring efficient workflows
• Analyze and interpret billing guidelines, state, federal and third party payer regulations
• Organize resources and establish priorities
• Develop, plan and implement short and long-range goals
• Foster a cooperative work environment
• Effectively manage staff, ensure employee development and oversee performance management

Benefits

• Health insurance
• Pension plan
• Vacation time
• Professional development opportunities
• Flexible working arrangements