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Cheyenne Regional Medical Center · 6 days ago

Revenue Integrity Administrator

Cheyenne, WY

Full-time

Onsite

Senior Level, Lead/Staff

8+ years exp

Cheyenne Regional Medical Center is the largest hospital in Wyoming, dedicated to providing trusted healthcare expertise. The Revenue Integrity Administrator leads the Revenue Integrity Division, ensuring effective revenue capture and compliance across the health system.

Health CareHospitalMedical

Hiring Manager

Courtney Strole

Responsibilities

Leads and oversees organization-wide Revenue Integrity and charge capture functions

Assist clinical departments with the deployment and continuous performance improvement efforts, for accurate and compliant charge submission. Drive execution and transformational change and leading-edge operations to contribute to Cheyenne Regional’s financial success

Assists annual price adjustment process through pricing models and vendor contract management variance reporting

Oversees Revenue Guardian, charge capture, reconciliation, and charge interfaces to ensure accurate charges across the healthcare organization

Collaborates with billing departments to establish and maintain charge capture audit processes, to check for appropriate coding and areas of potential revenue leakage

Collaborates with the Revenue Leadership Team to develop and execute monitoring tools to ensure effectiveness of revenue cycle projects and processes related to revenue capture (Accounts Receivable (AR) Days, timeliness of charge capture, Discharged Not Final Bill (DNFB), etc.) and automated processes

Manages and oversees development of policies, processes and workflows for hospital and professional coding, reviewing coding, medical necessity and level of care denials to ensure organizational best practices

Collaborates with Compliance department to ensure billing practice meets requirements across the health system

Oversees and manages the division’s budgetary and fiscal goals for reach of the departments

Analyzes patient estimates and provides guidance and reporting to assist patient experience

Reviews, analyzes and monitors organizational dashboards

Collaborates with the Revenue Cycle Administrator and Medical Director of Revenue Integrity to meet organizational goals and metrics relative to charging and coding of accounts

Participates in the Billing Grievance Committee to assist in monitoring and facilitating policies and regulatory compliance while meeting patient expectations

Participates, implements, and maintains Lean Methodology within the Revenue Integrity Division

Collaborates with clinical, financial, and operational departments to ensure optimal financial performance while maintaining high standards of accuracy, compliance, and efficiency

Collaborate with the Medical Director of Revenue Integrity to engage medical staff for denial prevention and documentation improvement initiatives

Qualification

Revenue Cycle ManagementMedical BillingCodingStatistical AnalysisInsurance Claim ProcessingRegulatory ComplianceProject ManagementLeadership SkillsExcelPowerPointWordCommunication SkillsProblem SolvingTime Management

Required

Bachelor's Degree or higher in Business Administration, Health Care Administration, Clinical Administration, Finance, and/or related field

Eight (8) or more years of hospital Revenue Cycle, Revenue Integrity, and/or reimbursement experience

Seven (7) or more years of management experience, with an emphasis on project management

Ability to apply appropriate management and leadership techniques and to manage multiple staff members in an operational setting

Advanced level of communication (verbal and written), interpersonal skills, problem solving, and organizational skills to maintain a high level of production and accuracy in an extremely task driven environment

Experience using Excel, PowerPoint, and Word

Excellent ability to understand and interpret statistical reports and perform quantitative analysis

Advanced skills in critical thinking and problem solving in a variety of settings and translation of data into actionable steps

Knowledge of insurance claim processing and third-party reimbursement

Knowledge of state and federal regulations as they pertain to billing processes and procedures

Knowledge of various types of provider reimbursement methodologies including per diems, inpatient Diagnosis-Related Groups (DRG)/All Patient Refined Diagnosis Related Groups (APRDRG) case rates, percent of charges, and outpatient surgery case rate methodologies

Knowledge of Revenue Cycle processes, medical billing and coding processes, detailed accounting principles, quantitative decision making, and process analysis

Ability to work independently, delegate responsibility, and take initiative across multiple workstreams

Time management and project management skills