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Revenue Integrity Manager

2 months ago

Roseville, United States Adventist Health Full time
Job Summary:

As a key member of the Adventist Health team, the Revenue Integrity Manager plays a critical role in ensuring the accuracy and compliance of revenue integrity functions across multiple sites. This position oversees the daily operations of revenue integrity, supporting the implementation of system-wide standardization and facilitating long-term strategies to meet expanding and changing needs.

Key Responsibilities:
  • Supports the creation and implementation of policies for operations, programs, and activities to achieve a compliant, standard charge master across the health system.
  • Leads a team of revenue integrity specialists, CDM coordinators, charge capture associates, charge assurance nurse auditors, and reporting and data analysts across the system.
  • Drives continuous improvement in revenue integrity and chargemaster activities, including the identification and implementation of applications and/or vendor partnerships to enhance operational performance.
  • Leverages automation through electronic health record (EHR) and technology to streamline processes and maximize the effectiveness of the department.
  • Supports all pricing strategies and pricing policies for Adventist Health, ensuring team adherence to established pricing guidelines.
  • Manages tasks within the department to ensure charge codes and charge capture processes exist for all patient services, medications, and supplies.
  • Reviews, monitors, and analyzes revenue performance and status on a regular basis to identify trends and strategize for continuous improvement and course correction.
  • Supports strategic audits to identify opportunities to streamline charge capture processes and increase net revenue.
  • Provides training and education to clinical, clerical, and professional staff regarding accurate and appropriate charge capture and reconciliation.
  • Ensures consistency in education, timely regulatory updates, and proper documentation standards and adherence to compliance initiatives.
Requirements:
  • Bachelor's Degree or equivalent combination of education/experience: Required
  • Master's Degree: Preferred
  • Five years' healthcare revenue cycle experience: Preferred
  • Application/technical work experience: Preferred
  • One year leadership experience: Preferred
  • Certification in Current Procedural Terminology (CPT) coding: Preferred
Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.