Manager Revenue Integrity Revenue Integrity DuBois CRC

Penn Highlands Healthcare has been awarded on the Forbes list of Best-in-State Employers 2022. This prestigious award is presented by Forbes and Statistica Inc., the world leading statistics portal and industry ranking provider.

Summary:

THE MANAGER, REVENUE INTEGRITY OVERSEES DAY-TO-DAY OPERATIONS OF THE CORPORATE REVENUE INTEGRITY DEPARTMENT, INCLUDING STAFF SUPERVISION, WORKLOAD MANAGEMENT, CLINICAL CHARGE AND DOCUMENTATION AUDITS, CDM SUPPORT, CHARGE CAPTURE COMPLIANCE, REVENUE LEAKAGE PREVENTION, EDUCATION, REPORTING, VENDOR COORDINATION, DENIALS PREVENTION, AND PROCESS IMPROVEMENT. THIS ROLE SUPPORTS ACCURATE, TIMELY, AND COMPLIANT REVENUE CAPTURE ACROSS HOSPITAL AND AMBULATORY SETTINGS BY MONITORING RECONCILIATION, EDIT RESOLUTION, AUDIT READINESS, KPI PERFORMANCE, AND PATIENT ACCOUNTING WORKFLOWS. THE MANAGER PARTNERS WITH INTERNAL STAKEHOLDERS, CONSULTANTS, AND VENDORS TO STRENGTHEN REVENUE INTEGRITY PROCESSES, COMMUNICATE PERFORMANCE TRENDS TO LEADERSHIP, SUPPORT REGULATORY COMPLIANCE, AND ADVANCE APPROPRIATE AUTOMATION AND OPTIMIZATION OF REVENUE INTEGRITY AND CHARGE MASTER PROCESSES.

Other information:

QUALIFICATIONS:

• BACHELOR’S DEGREE IN A HEALTHCARE, BUSINESS, FINANCE, HEALTH ADMINISTRATION, NURSING, CLINICAL, OR RELATED FIELD REQUIRED. EQUIVALENT EXPERIENCE MAY BE ACCEPTED IN LIEU OF EDUCATION. MASTER’S DEGREE PREFERRED.
• MINIMUM OF 5 YEARS OF EXPERIENCE IN REVENUE CYCLE, REVENUE INTEGRITY, CLINICAL OPERATIONS, CHARGE CAPTURE, DOCUMENTATION INTEGRITY, CODING, BILLING, COMPLIANCE, OR A RELATED HEALTHCARE SETTING. LEADERSHIP EXPERIENCE PREFERRED. STRONG ANALYTICAL, COMMUNICATION, ORGANIZATIONAL, AND PROJECT MANAGEMENT SKILLS REQUIRED. KNOWLEDGE OF MEDICAL RECORDS, HOSPITAL BILLING, PAYER REGULATIONS, CMS GUIDANCE, CPT, HCPCS, ICD-10, REVENUE CODES, MODIFIERS, LCD/NCD, OPPS/APC, IPPS/DRG, MEDICAL NECESSITY, AND NCCI REQUIREMENTS REQUIRED.
• CLINICAL LICENSURE, CODING, BILLING, COMPLIANCE, OR REVENUE INTEGRITY CERTIFICATION PREFERRED. EXPERIENCE WITH CERNER/ORACLE, MEDITECH, CPSI, CDM MAINTENANCE, CHARGE RECONCILIATION, REVENUE ANALYTICS, PATIENT ACCOUNTING SYSTEMS, AND MULTI-FACILITY OPERATIONS STRONGLY PREFERRED.

WHAT WE OFFER:

• Competitive Compensation
• Shift Differential
• Professional Development
• Supportive and Experienced Peers

BENEFITS:

• Medical, Dental, and Vision offered after completion of introductory period
• Paid Time Off
• 403(b) retirement plan with company match
• Company Paid Short & Long Term disability coverage
• Company Paid and Voluntary Life Insurance
• Flex Spending Account
• Employee Assistance Program (EAP)
• Health & Wellness Programs