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 will oversee the daily revenue integrity functions that support accurate charging and billing in compliance with state and federal regulations across the health system. This role will support the implementation of system-wide standardization and facilitate long-term strategies to meet expanding and changing needs, in collaboration with operational and clinical leadership.

Key Responsibilities:
  • Revenue Integrity: Ensure that processes and data meet standards established by regulatory bodies and Adventist Health executive leadership.
  • Leadership: Lead a team of revenue integrity specialists, CDM coordinators, charge capture associates, charge assurance nurse auditors, and reporting and data analysts across the system.
  • Continuous Improvement: Drive continuous improvement in revenue integrity and chargemaster activities, including the identification and implementation of applications and/or vendor partnerships that enhance operational performance.
  • Automation and Technology: Leverage automation through electronic health record (EHR) and technology to streamline processes and maximize the effectiveness of the department.
  • Pricing Strategies: Support all pricing strategies and pricing policies for Adventist Health, and ensure team follows established pricing guidelines.
  • Financial Analysis: Compile complex financial analysis to understand gross and net revenue implications of charging decisions and/or assess compliance issues.
  • Revenue Performance: Review, monitor, and analyze revenue performance and status on a regular basis to identify trends and strategize for continuous improvement and course correction.
  • Education and Training: Provide training and education to clinical, clerical, and professional staff regarding accurate and appropriate charge capture and reconciliation.
  • Communication: Manage department communication and education of charge capture related workflows, including identified changes in processes, structures, or systems/functionality.
Requirements:
  • Education: Bachelor's Degree or equivalent combination of education/experience.
  • Experience: Five years' healthcare revenue cycle experience, with leadership experience preferred.
  • Certifications: Certification in Current Procedural Terminology (CPT) coding is 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.



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