Manager Revenue Integrity
Southeast Health
Southeast. Always the right career direction.
Job Description Summary
The Manager of Revenue Integrity has managerial oversight for the Revenue Integrity Team to ensure all team components function in a cohesive, aligned, and productive manner to meet and anticipate the hospital’s current and future business needs.
Job Description
POSITION RESPONSIBILITIES:
The Revenue Integrity Manager will facilitate improvement in the overall quality, completeness, and accuracy of the Revenue capture process. Reporting directly to the Reimbursement/Decision Support Director, this individual will work independently and identify trends and root-cause for improvement opportunities in the Charge Description Master content, charge capture processes, charge related regulatory compliance, and claim denial rates. Develop and implement action plans to address all charging issues. Will facilitate CDM, coding, charge capture and documentation improvements to optimize net revenue and reduce denials. Provide support, education, and guidance to Clinical and Administrative departments to optimize appropriate revenue for the Healthcare System. Help to ensure that all patient charges meet medical necessity guidelines and are appropriately documented in the medical record.
QUALIFICATIONS:
+ Bachelor level degree preferred;
+ Three (3) to five (5) year’s financial/analytical experience in hospital setting;
+ Working knowledge of medical terminology and ICD-9- and CPT-4/HCPCS Coding;
+ Excellent computer skills;
+ Working knowledge of Craneware Chargemaster Took Kit preferred;
+ EPIC Charging/CDM experience/certification preferred
SKILLS:
+ Ability to read, write, and speak English;
+ Ability to communicate current understanding of Revenue Integrity best practices and technology trends;
+ Excellent interpersonal skills with the ability to engage at all levels of the organization; demonstrate a professional and adaptable demeanor with internal and external clients, including administrators, physicians, peers, and support staff;
+ Proficiency in Microsoft Office, including Word, Excel, and other applicable computer applications;
+ Proficiency in monitoring, organizing, and auditing charge capture;
+ Proficiency with Medicare and other third-party medical review policies;
+ Ability to coordinate multiple group efforts within the organization to achieve objectives;
+ Ability to work with minimum supervision, set priorities, and follow through to accomplish results;
+ Highly motivated self-starter comfortable leading and managing in the listed areas of responsibility.
Shift
DayShift Details
8:00 am - 4:30 pm
FTE
1
Type
Regular
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Equal Employment Employer
Southeast Health is committed to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Southeast Health will provide reasonable accommodations for qualified individuals with disabilities.
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