Manager Revenue Integrity

SUMMARY

Responsible for strategic planning and coordination through supervisors and analysts of day-to-day operations in Revenue Integrity. Manages the organization's revenue administration functions, which includes revenue assurance, revenue management, contract management, and billing. Responsible for ensuring integration of all front and back end processes, creation of transparency, maintenance of the revenue cycle, ensuring compliance with all administrative and contractual protocol, and other administrative aspects of the departments.

RESPONSIBILITIES

• Work across the system with all areas of clinical, business and IT to enhance the EMR system, improve on revenue recognition, and revenue enhancement.

• Facilitate the ongoing build and testing of EMR system. Develop teams or processes to improve Revenue Cycle effectiveness.

• Contributes to strategic planning, direction, and goal setting for the department or function.

• Recommends policies, practices, and procedures that have a significant impact on the organization.

• Administers processes and controls meant to ensure that revenue capture is accurate and maximized.

• Manages a team of analysts that identify ways to prevent revenue leakage or loss, reduce costs associated with business operations or revenue capture, or improve margins.

• Maintain a working knowledge of clinical documentation requirements and assist in developing clinical process changes to ensure revenue capture.

• Maintain a working knowledge of third party data requirements and collection laws. Constantly monitor these requirements and laws as they relate to activities in the departments.

• Completes capture of patient revenue in every area that generates charges, management in relation to charging mechanisms and triggers, ensuring clean handoffs between clinical departments, denials management, billing management and clinical operations relations

• Plan, manage, direct, and supervise the activities of personnel engaged in denials management for services rendered by CAMC.

• Plan for changes in third party reimbursement mechanisms, in advance of their occurrence whenever possible, and adjust departmental policies and procedures accordingly.

• Develop education and training to utilize for new hires, in addition to continuing education for current staff via process improvement meetings, educational sessions, and single point lessons.

EDUCATION

Master’s Degree in Business Administration or Related Field and 2 years management experience preferable in a Healthcare Revenue Cycle Related role.

Substitution – Bachelor’s Degree in Business Administration or related field and 3 years of management experience preferable in a Healthcare Revenue Cycle related role.

Work Schedule: Days

Status: Full Time Regular 1.0

Location: General Hospital

Location of Job: US:WV:Charleston

Talent Acquisition Specialist: Tamara B. Young tammy.young@vandaliahealth.org