Revenue Integrity Manager

4 weeks ago

Houston, United States Nexus Health Systems Full time
POSITION SUMMARY:

Under general direction from the Corporate Director, Revenue Cycle - the Manager, Revenue Integrity leads organizational initiatives related to Chargemaster, Facility Coding, Professional Coding, Charge Capture, Charge Reconciliation, Physician Documentation, Payer-specific Coding Requirements, and/or State-specific Coding Requirements. The Manager of Revenue Integrity will develop and maintain relationships with external and internal stakeholders and foster improvements collaboratively across the organization.

JOB SPECIFIC RESPONSIBILITIES:
  • Maintain utmost level of confidentiality at all times.
  • Adhere to health system policies and procedures.
  • Demonstrate ethical business practices and personal actions and adhere to corporate compliance and integrity guidelines.
  • Maintains a sense of professionalism and self-validation.
  • Ability to communicate effectively with all stakeholders across the health system.
  • Responsible for promoting adherence to applicable State/Federal laws and regulations and the program requirements of accreditation agencies and Federal/State and private health plans in requests for third-party reimbursement.
  • Evaluate the use of Revenue Cycle electronic systems and offer recommendations to maximize reporting and revenue integrity accuracies.
  • Acts as a Revenue Integrity liaison with various IT teams handling various EMR modules to set up and maintain accurate charges flow.
  • Coordinates the administrative, legal, operational, and financial issues related to Revenue Integrity data with appropriate departments
  • Participate and lead the development and management of Revenue Integrity projects, workflows, and application builds.
  • Assist with the strategic and financial judgment necessary for profitable organizational growth.
  • Responsible for timely research and evaluation of Medicaid and Medicare regulations, as well as Commercial Payer regulations and changes to optimize reimbursement
  • Supports and participates in continuously assessing and improving the quality of care and services provided.
  • Performs Inpatient and Outpatient coding, including, but not limited to, DX, DRG, CPT, HCPCS, Modifiers, etc.
  • Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations.
  • Audits clinical documentation and coded data to validate documentation support services rendered for reimbursement and reporting purposes.
  • Participate in denials and appeals related to coding or clinical documentation.
  • Develop and maintain a Revenue Integrity policy and standard operating procedures.
  • Develop and maintain a Charge Description Master (CDM) for administered services and procedures.
  • Identifies KPIs for Revenue Integrity initiatives and collaborates with key stakeholders towards process improvements.
  • Identifies and interprets trends and patterns within Revenue Integrity and recommends resolution
  • Participate in new service or business line research and assessments.
  • Assists and participates in the development of department policies.
  • Develops and maintains revenue Integrity reporting.
  • Perform extensive data mining and testing of financial and clinical information from various decision support tools and software, as needed, for effective and accurate department reporting.
  • Maintains positive working relationships with other organizational departments such as Accounting & Finance, HIM, Compliance, and the Medical Staff to ensure the departments' responsibilities are performed expeditiously and thoroughly.
  • Performs other duties as assigned.
POSITION QUALIFICATIONS:

EDUCATION:
  • Associate's Degree in Nursing (RN) or Bachelor of Science in Nursing (BSN)
EXPERIENCE:
  • Minimum three years experience in the same or similar position.
LICENSURE/CERTIFICATION:
  • Current Core Inpatient Coding Certification from AAPC or AHIMA, such as CIC or CCS
  • CPP desired
  • Must pass a criminal background check on an annual basis.

  • Revenue Integrity Manager

    5 days ago

    Houston, Texas, United States Nexus Health Systems Full time

    POSITION SUMMARY: Under general direction from the Corporate Director, Revenue Cycle - the Manager, Revenue Integrity leads organizational initiatives related to Chargemaster, Facility Coding, Professional Coding, Charge Capture, Charge Reconciliation, Physician Documentation, Payer-specific Coding Requirements, and/or State-specific Coding Requirements. The...

  • Revenue Integrity Manager

    2 months ago

    Houston, United States Nexus Health Systems Ltd Full time

    Job DescriptionJob DescriptionPOSITION SUMMARY:Under general direction from the Corporate Director, Revenue Cycle – the Manager, Revenue Integrity leads organizational initiatives related to Chargemaster, Facility Coding, Professional Coding, Charge Capture, Charge Reconciliation, Physician Documentation, Payer-specific Coding Requirements, and/or...

  • Revenue Integrity Manager

    2 months ago

    Houston, United States Nexus Health Systems Ltd Full time

    Job DescriptionJob DescriptionPOSITION SUMMARY:Under general direction from the Corporate Director, Revenue Cycle – the Manager, Revenue Integrity leads organizational initiatives related to Chargemaster, Facility Coding, Professional Coding, Charge Capture, Charge Reconciliation, Physician Documentation, Payer-specific Coding Requirements, and/or...

  • Revenue Integrity Manager

    3 weeks ago

    Houston, United States Nexus Health Systems Ltd Full time

    Job DescriptionJob DescriptionPOSITION SUMMARY:Under general direction from the Corporate Director, Revenue Cycle – the Manager, Revenue Integrity leads organizational initiatives related to Chargemaster, Facility Coding, Professional Coding, Charge Capture, Charge Reconciliation, Physician Documentation, Payer-specific Coding Requirements, and/or...

  • Revenue Integrity Manager

    3 weeks ago

    Houston, United States Nexus Health Systems Ltd Full time

    Job DescriptionJob DescriptionPOSITION SUMMARY:Under general direction from the Corporate Director, Revenue Cycle – the Manager, Revenue Integrity leads organizational initiatives related to Chargemaster, Facility Coding, Professional Coding, Charge Capture, Charge Reconciliation, Physician Documentation, Payer-specific Coding Requirements, and/or...

  • Director, Professional Revenue Integrity

    1 month ago

    Houston, United States Memorial Hermann Health System Full time

    At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...

  • Director, Professional Revenue Integrity

    2 weeks ago

    Houston, United States Memorial Hermann Health System Full time

    At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...

  • Director, Professional Revenue Integrity

    4 weeks ago

    Houston, United States Memorial Hermann Full time

    At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...

  • Director, Professional Revenue Integrity

    1 month ago

    Houston, United States Memorial Hermann Full time

    At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...

  • Director, Professional Revenue Integrity

    3 weeks ago

    Houston, United States Memorial Hermann Full time

    At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...

  • Revenue Manager

    1 week ago

    Houston, United States Crowne Plaza Houston Med Ctr-Galleria Area, an IHG Hotel Full time

    We have an exciting opportunity for an experienced **Revenue Manager.** In this position you will create a revenue management process for the entire property that results in sustained revenue growth. **Responsibilities**: - Analyzes revenue for all business segments - Ensures the integrity of all forecasting for rooms/meeting space - Completes forecasts...

  • Manager - Revenue Accounting

    2 months ago

    Houston, United States Citation Oil & Gas Full time

    Overview The successful candidate will be joining one of the largest privately-held independent oil & gas acquisition, development, and production companies in the U.S. Citations assets consist of more than 430 fields located in 13 states that have more than 257 million net equivalent barrels of remaining proved reserves (82% oil, 71% developed). Citation...

  • Manager - Revenue Accounting

    2 months ago

    Houston, United States Citation Oil & Gas Corp. Full time

    OverviewThe successful candidate will be joining one of the largest privately-held independent oil & gas acquisition, development, and production companies in the U.S. Citation’s assets consist of more than 430 fields located in 13 states that have more than 257 million net equivalent barrels of remaining proved reserves (82% oil, 71% developed). Citation...

  • Manager - Revenue Accounting

    2 months ago

    Houston, United States Citation Oil & Gas Corp. Full time

    OverviewThe successful candidate will be joining one of the largest privately-held independent oil & gas acquisition, development, and production companies in the U.S. Citation’s assets consist of more than 430 fields located in 13 states that have more than 257 million net equivalent barrels of remaining proved reserves (82% oil, 71% developed). Citation...

  • Business Development Manager

    2 months ago

    Houston, United States ECS Integrity Full time

    Job DescriptionJob DescriptionSalary: The ECS Integrity Team serves a diverse set of end markets including manufacturing, pipeline and maritime. Summary: ECS Integrity is seeking a fulltime Business Development Manager with an entrepreneurial spirit that enjoys building a business in a competitive NDT market where we may be under developed. This may entail...

  • Business Development Manager

    3 weeks ago

    Houston, United States ECS Integrity Full time

    Job DescriptionJob DescriptionSalary: The ECS Integrity Team serves a diverse set of end markets including manufacturing, pipeline and maritime. Summary: ECS Integrity is seeking a fulltime Business Development Manager with an entrepreneurial spirit that enjoys building a business in a competitive NDT market where we may be under developed. This may entail...

  • Revenue Accounting Manager-co2

    4 weeks ago

    Houston, United States Kinder Morgan Full time

    Accounting manager responsible for all revenue accounting activities related the sale of lease revenue accounting for the CO2 business segment. This position reports to the Director of Revenue and has responsibility for managing a staff of 4 revenue accountants. **Responsibilities** - Manage all accounting activities for the lease revenue accounting and to...

  • Revenue Management Manager

    2 weeks ago

    Houston, United States Marriott International, Inc Full time

    **Job Number** 24100608 **Job Category** Revenue Management **Location** Marriott Marquis Houston, 1777 Walker Street, Houston, Texas, United States VIEW ON MAP **Schedule** Full-Time **Located Remotely?** N **Relocation?** Y **Position Type** Management Marriott offers relocation assistance for this job opening which is US: Plan 1. Please visit MGS...

  • Revenue Accounting Manager-CO2

    5 days ago

    Houston, Texas, United States Kinder Morgan Full time

    Position Description Accounting manager responsible for all revenue accounting activities related the sale of lease revenue accounting for the CO2 business segment. This position reports to the Director of Revenue and has responsibility for managing a staff of 4 revenue accountants. Responsibilities Manage all accounting activities for the lease revenue...

  • Revenue Management Manager

    2 weeks ago

    Houston, United States Marriott International Full time

    Job Description Marriott offers relocation assistance for this job opening which is US: Plan 1. Please visit MGS for details on the relocation policies. JOB SUMMARY Manages rooms and function space inventory and ensures inventory is allocated and restricted properly to maximize revenue and profits for hotels in the market. Responsible for building rates,...