9 Manager, Revenue Integrity (FT) Jobs in Boston, MA
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Manager, Revenue Integrity (FT)
$125k-166k (estimate)
Full Time | Social & Legal Services
6 Months Ago
East Boston Neighborhood Health Center is Hiring a Manager, Revenue Integrity (FT) Near Boston, MA
Manager, Revenue Integrity
East Boston, MA
Full-time, benefit eligible
The Manager, Revenue Integrity develops, coordinates, and provides oversight to a diverse team of staff performing revenue functions. This role works in collaboration with finance, compliance, revenue cycle, and clinical operations to promote accurate contracting, charging, and reconciliation in accordance with governmental and third party payer policies and procedures. This is accomplished by developing team members and organizational policies to maintain efficient procedures that address contracting, revenue reporting, performance analytics, charge capture, cash reconciliation, process improvement, change control, denial trending, timely response and documentation for internal and external audits , monitoring and communicating governmental and third party payer policy changes.
The Manager is required to maintain current knowledge of Medicare, Medicaid, and third party payer policies and procedures to ensure revenue functions meet governmental mandates and payer contractual and policy expectations. Monitors external audit and denial activity to identify trends and work with impacted departments to develop/update documentation and training tools which can be used to strengthen front-end processes. Knowledge in payer contracts to create a process for contract performance management, term negotiation, rate review, and charge master updates. Creates a process for team to monitor and communicate governmental and third party payer policy changes to ensure compliance. Develops charge integrity and reconciliation process to ensure accurate charge capture procedures are in place. Communicates opportunities with operational leaders to educate and drive improvement. Collaborates with operational leaders to support expansion of services that meet governmental and third party payer requirements. Partners with leadership in completing an Annual Risk Assessment and developing the upcoming Annual Work Plan. Establishes, implements, and maintains a formalized process for compliance; designs and uses audit tools to monitor the accuracy and productivity of revenue integrity team members. Develops goals and performance expectations, coaches, evaluates, and motivates team members. Accountable for hiring, performance management, payroll and payroll practices to ensure alignment with organizational philosophies.
East Boston, MA
Full-time, benefit eligible
The Manager, Revenue Integrity develops, coordinates, and provides oversight to a diverse team of staff performing revenue functions. This role works in collaboration with finance, compliance, revenue cycle, and clinical operations to promote accurate contracting, charging, and reconciliation in accordance with governmental and third party payer policies and procedures. This is accomplished by developing team members and organizational policies to maintain efficient procedures that address contracting, revenue reporting, performance analytics, charge capture, cash reconciliation, process improvement, change control, denial trending, timely response and documentation for internal and external audits , monitoring and communicating governmental and third party payer policy changes.
The Manager is required to maintain current knowledge of Medicare, Medicaid, and third party payer policies and procedures to ensure revenue functions meet governmental mandates and payer contractual and policy expectations. Monitors external audit and denial activity to identify trends and work with impacted departments to develop/update documentation and training tools which can be used to strengthen front-end processes. Knowledge in payer contracts to create a process for contract performance management, term negotiation, rate review, and charge master updates. Creates a process for team to monitor and communicate governmental and third party payer policy changes to ensure compliance. Develops charge integrity and reconciliation process to ensure accurate charge capture procedures are in place. Communicates opportunities with operational leaders to educate and drive improvement. Collaborates with operational leaders to support expansion of services that meet governmental and third party payer requirements. Partners with leadership in completing an Annual Risk Assessment and developing the upcoming Annual Work Plan. Establishes, implements, and maintains a formalized process for compliance; designs and uses audit tools to monitor the accuracy and productivity of revenue integrity team members. Develops goals and performance expectations, coaches, evaluates, and motivates team members. Accountable for hiring, performance management, payroll and payroll practices to ensure alignment with organizational philosophies.
EDUCATION:
- Bachelor's Degree required in related field, Master’s degree preferred.
EXPERIENCE:
- years health care billing management experience
- Knowledge of healthcare administrative processes such as reimbursement policies and procedures, payer contracting, operations and billing regulations
- Strong management and staff development skills
- Proven analytics and performance improvement
- Knowledge of health care industry trends
- Extensive knowledge of Federal and State insurance programs (MassHealth)
- Experience interpreting medical records
- Experience interacting with physicians and clinical support regarding coding guidelines (written and verbal)
- Extensive knowledge of Revenue codes, CPT, and ICD-10 coding across multiple medical specialties
- Ability to lead, supervise, and train staff
- EPIC experience preferred
SKILLS/ABILITIES:
- Knowledge of medical terminology, ICD-10 and CPT Coding, computer programs.
- Effective oral and written communication skills.
Benefits:
- Medical, Dental, and Vision Coverage
- Life and Disability Insurance
- 401(K) Retirement Plan
- Tuition Reimbursement
- Flexible Spending and Transportation Accounts
- Paid Holidays, Vacations, Sick, and Personal Time
- Generous Staff Development Benefit
- Excellent Malpractice Coverage
- Pet Insurance
- Free Parking and much more
EBNHC opens our doors to people from all demographics and cultures. Our workforce is as diverse as the city we call home — in gender, race, ethnicity, sexual orientation, disability, religion, and age, as well as in cultural backgrounds, life experiences, thoughts, and ideas.
Job Summary
JOB TYPE
Full Time
INDUSTRY
Social & Legal Services
SALARY
$125k-166k (estimate)
POST DATE
11/05/2023
EXPIRATION DATE
05/23/2024
HEADQUARTERS
WINTHROP, MA
SIZE
1,000 - 3,000
FOUNDED
2011
CEO
JOHN H LYNCH
REVENUE
$50M - $200M
INDUSTRY
Social & Legal Services
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The job skills required for Manager, Revenue Integrity (FT) include Transportation, Leadership, Billing, Process Improvement, Written Communication, etc. Having related job skills and expertise will give you an advantage when applying to be a Manager, Revenue Integrity (FT). That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Manager, Revenue Integrity (FT). Select any job title you are interested in and start to search job requirements.
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