Work where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemPosition SummaryReporting to the Revenue Integrity Director this role is a subject matter expert focused on improving revenue results by analyzing clinical and financial processes This role supports outpatient departments that include hospitals services for revenue generating clinical departments Responsibilities includes oversight and leadership for a team responsible for capturing appropriate revenue and reimbursement and denial prevention Manages and monitors the results data analysis and root cause issue and assists departments with corrective action plans This position provides management and coordination of education and serves as a facility liaison to the HHC clinical departments as it relates to charging late charges medical necessity issues and reconciliation efforts that department staff should complete to meet billing periods Responsible for building collaborative relationships with HHC clinical and administrative leadership and other key stakeholders Billing AR Follow Up HIM and IT Motivates and challenges staff to achieve the highest levels of performance working in conjunction with all key stakeholders to prevent revenue deficits and optimize potential revenue Responsible for managing the optimization of staff performance through process redesign policyprocedure implementation communications continuing education and professional development activitiesPosition ResponsibilitiesKey Areas of ResponsibilityLeads a team focusing on denial prevention initiatives related to clinical documentation charge assignment and medical necessity providing recommendations and corrective actions for improving denial trends and write offs Includes assist in the CPT code validation for charging purposes as it relates to CDM maintenanceProvides expertise to assist and educate staff on charging CPT and regulatory guidelines including OPPS regulations Function as a liaison to bridge any communication gaps and foster collaboration among departments Requires a high level of service focus project management and the ability to lead coach and mentor analystsLeads a team that evaluates researches and analyzes revenue and charging data to perform root cause analysis and ensure compliance with government payer requirements to determine patterns of charging that will increase the propensity for payment of charged servicesFocuses on improving revenue results by analyzing clinical and financial processes Works with the clinical areas directly to support charging accuracy initiatives and as a liaison from Revenue IntegrityPrepares reports to the Revenue Integrity Director regarding issues outcomes and corrective actionsDevelops relationships with various committees and groups to ensure continuity in processes that increase revenue capture Maintains a rapport and frequent visibility with all contacts that will foster a trusting relationship encourage discovery of revenue capture opportunitiesWorking RelationshipsThis Job Reports To Job Title System Director Revenue IntegrityJob Titles of HHC positions reporting to this Job Revenue Integrity AnalystsNumber Direct Reports FTE and contracting resourceNumber Indirect Reports Work where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemPosition SummaryReporting to the Revenue Integrity Director this role is a subject matter expert focused on improving revenue results by analyzing clinical and financial processes This role supports outpatient departments that include hospitals services for revenue generating clinical departments Responsibilities includes oversight and leadership for a team responsible for capturing appropriate revenue and reimbursement and denial prevention Manages and monitors the results data analysis and root cause issue and assists departments with corrective action plans This position provides management and coordination of education and serves as a facility liaison to the HHC clinical departments as it relates to charging late charges medical necessity issues and reconciliation efforts that department staff should complete to meet billing periods Responsible for building collaborative relationships with HHC clinical and administrative leadership and other key stakeholders Billing AR Follow Up HIM and IT Motivates and challenges staff to achieve the highest levels of performance working in conjunction with all key stakeholders to prevent revenue deficits and optimize potential revenue Responsible for managing the optimization of staff performance through process redesign policyprocedure implementation communications continuing education and professional development activitiesPosition ResponsibilitiesKey Areas of ResponsibilityLeads a team focusing on denial prevention initiatives related to clinical documentation charge assignment and medical necessity providing recommendations and corrective actions for improving denial trends and write offs Includes assist in the CPT code validation for charging purposes as it relates to CDM maintenanceProvides expertise to assist and educate staff on charging CPT and regulatory guidelines including OPPS regulations Function as a liaison to bridge any communication gaps and foster collaboration among departments Requires a high level of service focus project management and the ability to lead coach and mentor analystsLeads a team that evaluates researches and analyzes revenue and charging data to perform root cause analysis and ensure compliance with government payer requirements to determine patterns of charging that will increase the propensity for payment of charged servicesFocuses on improving revenue results by analyzing clinical and financial processes Works with the clinical areas directly to support charging accuracy initiatives and as a liaison from Revenue IntegrityPrepares reports to the Revenue Integrity Director regarding issues outcomes and corrective actionsDevelops relationships with various committees and groups to ensure continuity in processes that increase revenue capture Maintains a rapport and frequent visibility with all contacts that will foster a trusting relationship encourage discovery of revenue capture opportunitiesWorking RelationshipsThis Job Reports To Job Title System Director Revenue IntegrityJob Titles of HHC positions reporting to this Job Revenue Integrity AnalystsNumber Direct Reports FTE and contracting resourceNumber Indirect Reports Requirements and SpecificationsEducationmiddot Minimum Bachelors degree in healthcare administration finance business administration or related field OR Ten years of experience in healthcare related revenue cycle functions including coding and billing guidelines may be substituted for a bachelorrsquos degreemiddot Preferred Bachelors degree in healthcare administration finance business administration or related field OR Ten years of experience in healthcare related revenue cycle functions including coding and billing guidelines may be substituted for a bachelorrsquos degreeExperiencemiddot Minimum Ten years of experience with two years supervisory experience in healthcare CDM maintenance charging practices coding billing collections andor denials in a hospitalambulatory settingmiddot Preferred Ten years of experience with two years supervisory experience in healthcare CDM maintenance charging practices coding billing collections andor denials in a hospitalambulatory settingLicensure Certification Registrationmiddot Minimum Valid Certified Coder Certification ie CPC CCS CPC Hmiddot Preferred Certified Healthcare Revenue Integrity CHRILanguage Skillsmiddot EnglishKnowledge Skills and Ability Requirements middot Coding Experience ndash Includes diagnosis CPT and HCPCS codesmiddot Experience coding ambulatory surgery records and applying NCCI edit rulesmiddot Understanding of Medicarersquos Outpatient Prospective Payment System OPPSmiddot Experience with denial data and associated remark codes etcWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour momentRequirements and SpecificationsEducationmiddot Minimum Bachelors degree in healthcare administration finance business administration or related field OR Ten years of experience in healthcare related revenue cycle functions including coding and billing guidelines may be substituted for a bachelorrsquos degreemiddot Preferred Bachelors degree in healthcare administration finance business administration or related field OR Ten years of experience in healthcare related revenue cycle functions including coding and billing guidelines may be substituted for a bachelorrsquos degreeExperiencemiddot Minimum Ten years of experience with two years supervisory experience in healthcare CDM maintenance charging practices coding billing collections andor denials in a hospitalambulatory settingmiddot Preferred Ten years of experience with two years supervisory experience in healthcare CDM maintenance charging practices coding billing collections andor denials in a hospitalambulatory settingLicensure Certification Registrationmiddot Minimum Valid Certified Coder Certification ie CPC CCS CPC Hmiddot Preferred Certified Healthcare Revenue Integrity CHRILanguage Skillsmiddot EnglishKnowledge Skills and Ability Requirements middot Coding Experience ndash Includes diagnosis CPT and HCPCS codesmiddot Experience coding ambulatory surgery records and applying NCCI edit rulesmiddot Understanding of Medicarersquos Outpatient Prospective Payment System OPPSmiddot Experience with denial data and associated remark codes etcWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment