Revenue Integrity Manager

4 days ago

GA 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 a project. Aspects to consider include Charge Capture, Charge Compliance, Audits/updates, 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 that ensure 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, operations, and staff assignments.
  • Hire, coach, evaluate, discipline, employees, and track productivity.
  • Serve as the resource for Epic Connect on issues requiring Revenue Integrity's expertise or assistance.
  • Coach, guide, and develop staff related to their responsibilities.
  • Manage change and process improvement.
  • Build and maintain a team.
  • Schedule and lead meetings.
  • Delegate project tasks based on junior staff members' individual strengths, skill sets, and experience levels.
  • Use and continually develop leadership skills.
  • Attend conferences and training as required to maintain proficiency.
  • Coordinate staff and internal resources related to projects assigned.
  • Manage or assist with departmental projects and requests.
  • Utilize knowledge of Wellstar Health System to assess resources needed to complete projects and fulfill requests.
  • Coordinate all activities that have a system-wide revenue impact.
  • Direct all aspects of Revenue Management department in the absence of the Director.
  • Attend system-wide meetings that require Revenue Integrity's attendance and input.
  • Build, lead, 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 that 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 that they adhere to quality standards.
  • Prepare status reports by gathering, analyzing, and summarizing relevant information.
  • Facilitate change requests to ensure that all parties are informed of the impacts on schedules.
  • 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/revise clinical workflow to optimize reimbursement.
  • Address charging, charge capture, and compliance issues that adversely affect revenue-generating departments.
  • Provide education to charge-generating departments to assure 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 in which process improvements may be required.
  • 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 project transition period.
  • Optimize and improve processes and the overall approach where necessary.
  • Secure growth opportunities and initiate new projects.
Required Minimum Education

Bachelor's Degree Required and Master's Degree Preferred.

Required Minimum License(s) and Certification(s)
  • Cert Coding Associate or Cert Coding Spec or Cert Prof Coder.
Additional License(s) and Certification(s)

Clinical Certification/License or certified Coder by AAPC or AHIMA Required.

Required Minimum Experience

Minimum 5 years of Revenue Integrity/Chargemaster Management experience overseeing multi-disciplinary, complex charging and capture workflows Required and Extensive knowledge of revenue cycle, clinical services, and regulatory compliance Required.

Required Minimum Skills

Must have outstanding communication and presentation skills. Good communicator, self-starter, creative problem solver, and highly organized. Must have advanced Microsoft Office skills, be comfortable interacting with physicians, administrators, and all levels of senior management.

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