Revenue Integrity Manager
About The Position
This position is responsible for the daily management and direction of the Revenue Integrity function under the oversight of the CFO and VP, Revenue Cycle at SRC This leader will perform audits and reviews of departmental charge capture and reconciliation, denials management for all campuses, daily reporting and coordinated work on unbilled/DNFB, departmental education on the aforementioned functions, and the identification and implementation of process improvement opportunities, in collaboration with Revenue Cycle and hospital and clinic operations, in order to enhance revenue potential and compliance This role interfaces with hospital and clinic leadership, Billing and HIM staff, and department leadership and associates on a regular basis to ensure audits and corresponding action plans are done in a timely and effective manner Ensure revenue integrity functions, including charge capture, denials management, unbilled claims, and maintenance of chargemaster Provide support to departments to assist with appropriate charge capture and reconciliation Assure reports are run as scheduled, reports are distributed, and report inquiries are handled Reports included Unbilled claims, Denials Recap details/summary Maintain the Charge Master in a manner that is compliant with insurance requirements and government regulations (This includes regularly searching for updates and maintaining current and previous billing requirements.) Follow up on denials in order to analyze claims' denials and implement correction action plans with stakeholders including department leaders and physician Communicates regularly with dept Directors and responds promptly to inquiries, concerns and problems as pertains to the chargemaster Communicates with all dept Directors as new regulations and/or operational changes occur; maintains a positive dialogue and collaborative working environment Other duties as assigned.
Requirements
- Bachelor's Degree
- Three or more years of experience in a hospital or clinical setting with revenue integrity audit and compliance
Responsibilities
- Daily management and direction of the Revenue Integrity function
- Audits and reviews of departmental charge capture and reconciliation
- Denials management for all campuses
- Daily reporting and coordinated work on unbilled/DNFB
- Departmental education on charge capture, denials management, and unbilled claims
- Identification and implementation of process improvement opportunities
- Maintenance of chargemaster
- Follow up on denials in order to analyze claims' denials and implement correction action plans
- Communicates regularly with dept Directors and responds promptly to inquiries, concerns and problems as pertains to the chargemaster
- Communicates with all dept Directors as new regulations and/or operational changes occur
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What This Job Offers
Job Type
Full-time
Career Level
Manager
