Revenue Management Mgr

2 weeks ago

Lithia Springs, United States Wellstar Health System, Inc. Full time
Job Summary

The Manager of Revenue Integrity will be responsible for the successful initiation, planning, design, execution, monitoring, controlling, and closure of projects. Key aspects to consider include charge capture, charge compliance, audits, workflows, process improvement, change management, and staff responsibilities. The overall goal is to manage multi-faceted charge processes to optimize reimbursement and improve process efficiencies that enhance service delivery and cost controls, ensuring the health system's competitive position in the marketplace.

Core Responsibilities and Essential Functions
  • Manage the day-to-day operations of the Revenue Integrity department, including personnel management, staff assignments, and resource allocation.
  • Develop and implement processes to optimize reimbursement and improve process efficiencies.
  • Coach, guide, and develop staff related to their responsibilities.
  • Manage change and process improvement initiatives.
  • Build and maintain a high-performing team.
  • Lead meetings, delegate project tasks, and utilize leadership skills.
  • Attend conferences and training to maintain proficiency.
  • Coordinate staff and internal resources related to projects assigned.
  • Utilize knowledge of Wellstar Health System to assess resources needed to complete projects and fulfill requests.
  • Coordinate all activities with a system-wide revenue impact.
  • Direct all aspects of the Revenue Management department in the absence of the Director.
  • Attend system-wide meetings that require Revenue Integrity's attendance and input.
  • Build, lead, and participate in interdisciplinary project teams.
  • Address billing and compliance issues that adversely affect revenue-generating departments.
  • Ensure that all projects are delivered on-time, within scope.
  • Assist or create the definition of project scope and objectives.
  • Ensure resource availability and allocation when making project assignments.
  • Create and maintain project documentation.
  • Coordinate with cross-discipline team members to ensure all parties are on track with project requirements, deadlines, and schedules.
  • Meet with project team members to identify and resolve issues.
  • Maintain project deliverables and ensure they adhere to quality standards.
  • Prepare status reports by gathering, analyzing, and summarizing relevant information.
  • Facilitate change requests to ensure all parties are informed of the impacts on schedule.
  • Conduct post-project evaluation and identify successful and unsuccessful project elements.
  • Lead project planning sessions.
  • Develop internal controls to target revenue recovery by identifying charge capture, coding, and reimbursement problems.
  • Design, implement, and revise clinical workflows to optimize reimbursement.
  • Address charging, charge capture, and compliance issues that adversely affect revenue-generating departments.
  • Provide education to charge-generating departments to ensure timeliness and accuracy of charging.
  • Report and escalate to management as needed.
  • Develop spreadsheets, diagrams, and process maps to document needs.
  • Coordinate the development of user manuals, training materials, and other documents as needed to enable successful implementation and turnover of the process or system to the clients.
  • Oversee all incoming and outgoing project documentation.
  • Continuously monitor areas within the manager's influence for improvement to deliver high-quality service to both internal and external customers.
  • Encourage and motivate staff to continuously review areas for potential process improvements.
  • Evaluate general department processes for potential changes in effectiveness.
  • Build and maintain a strong network within the healthcare community.
  • Manage the relationship with the client and all stakeholders.
  • Identify and develop new opportunities with clients.
  • Obtain customer acceptance of project deliverables.
  • Manage customer satisfaction within the project transition period.
  • Optimize and improve processes and the overall approach where necessary.
  • Secure growth opportunities and initiate new projects.
Requirements
  • Bachelor's Degree Required; Master's Degree Preferred.
  • Certified Coding Associate or Certified Coding Specialist or Certified Professional Coder.
  • Clinical Certification/License or Certified Coder by AAPC or AHIMA Required.
  • Minimum 5 years of Revenue Integrity/Chargemaster Management experience overseeing multi-disciplinary, complex charging and capture workflows.
  • Extensive knowledge of revenue cycle, clinical services, and regulatory compliance.

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