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Memorial Healthcare System · 3 days ago

Revenue Integrity Manager - FT - Days - MHS

Hollywood, FL

Full-time

Onsite

Senior Level

5+ years exp

Memorial Healthcare System is dedicated to improving the health and quality of life for the people they serve. The Manager of Revenue Integrity is responsible for overseeing daily operations and managing a team to optimize revenue capture and ensure compliance with regulatory standards.

Health Care

Responsibilities

Manages the planning of application development and deployment; educates and promotes adherence to the organization's software compliance standards within the team

Strategic focus: based on regulatory and industry updates, MHS strategic initiatives, end-user feedback, and other information, identifies and achieves opportunities to improve charge capture efficiency and accuracy, eliminate missed charges, eliminate billing rework, and improve MHS net revenue

Keeps current, timely reads, and analyzes Medicare, Medicaid, and other technical guidance to determine how they affect Memorial Healthcare System (MHS) capture

Develops, recommends, and implements plans to comply with regulatory updates as approved by the Director of Revenue Integrity and in collaboration with responsible MHS leaders

Develops annual CDM CPT/HCPCS updates and implements as approved by the Director of Revenue Integrity. Includes working with operational departments to identify applicable new or revised codes

Oversees the maintenance of CDM-driven CPT/HCPCS coding requirements

Develops annual CDM Fee Schedule updates and implements as approved by the Director of Revenue Integrity

Updates Price Transparency Standard Charges file in accordance with regulatory requirements

Manages and monitors staffing activities including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives

Periodically tests samples of departmental charges to evaluate whether staff members are performing correctly, and controls are operating as designed

Works with RCM and departmental staff to provide as-needed retraining as well as regular periodic updates for all charge capture staff

Monitors and provides training, support and troubleshooting to both application teams and end-users to facilitate proper usage and continuous learning

Manages applications projects including workflow analysis, end-user validation, acceptance, go-live, and maintenance using standard project management methodology

Sets project deadlines and deliverables for specific modules and analysis

Manages the debugging and enhancements processes including the design and upgrades to existing systems in order to ensure up-to-date and reliable functionality

Utilizes subject matter expert skills to assist MHS leaders with analyses of billing, coding, and documentation requirements for payer coverage and payment of services affecting their service lines and initiatives

Designs and evaluates the tools and processes used to capture charges in each MHS department

Updates the design of tools to empower departmental staff to accurately post charges efficiently, without rework

Designs and implements controls to empower departmental leaders to ensure staff have captured charges accurately and timely

Ensures Epic charge-related work queues are timely and correctly cleared

Selects opportunities identified by team to implement and improve existing processes using information technology and ensures alignment with strategic initiatives of the organization

Qualification

Epic Charge Router CertificationEpic Resolute Billing CertificationCharge capture processesCoding credential AHIMACoding credential AAPCTeam managementCustomer serviceCritical thinkingEffective communicationDecision makingOrganization skillsTeamwork