Revenue Integrity Manager
2 weeks ago
Parrish Medical Center is seeking a highly skilled Revenue Integrity Manager to join our team. As a key member of our revenue cycle team, you will be responsible for promoting and demonstrating our Culture of Choice, actively participating in ensuring strategic goals and objectives are met or exceeded, and providing management and oversight necessary to ensure assigned functional areas have the proper resources, metrics, and talent in place to effectively fulfill our mission to provide Healing Experiences for Everyone all the Time and achieve organizational strategic (Game Plan) goals.
Key Responsibilities:- HEALING COMMUNITIES | GROWTH
- Manage operational planning within assigned functional areas to anticipate current/future service solutions.
- Implement growth strategies to support achievement of Parrish Healthcare Game Plan goals.
- Assure achievement of departmental dashboard metrics within each strategic pillar (People, Service, Quality, Growth, Finances); take immediate and effective steps to assure national benchmarks are achieved or sustained.
- HEALING EXPERIENCES | SERVICE
- Manage departmental systems, processes, policies, and procedures that result in assigned areas of responsibility and care partners always providing excellent service excellence as measured by national best-practice benchmarks.
- SYSTEM RELIABILITY | QUALITY & SAFETY
- Optimize patient charge structure for revenue capture and billing within regulatory and payer compliance guidelines. Develop, manage, and reinforce process improvement activities in areas of charge capture integration and reconciliation, CDM compliance, Managed-Care Contracting, Payer Medical and Billing Policies.
- Research, audit, and analyze data, creating solutions and/or alternatives; present data to stakeholders.
- Manage CDM activity and accuracy of 98%+. Vendor liaison for all associated engagements. Maintain direct contact with internal and external vendors associated with revenue integrity initiatives.
- Monitor and report monthly denials and late charges.
- Work closely with the Billing Manager to ensure claims data represents what was performed and billed appropriately per payer-directed requirements, thus maximizing reimbursement.
- Ensure revenue cycle strategic goals and objectives are met or exceeded by providing management and oversight necessary to ensure areas of responsibility have the proper resources, metrics, and talent in place to effectively achieve Game Plan Goals.
- CARE PARTNER ENGAGEMENT | PEOPLE
- Manage systems, processes, policies, and procedures that result in an inclusive, collaborative, healing work environment within which national best/leading-practice standards for employee engagement are achieved as measured by effective performance management, problem-solving and conflict resolution, mentoring aspiring care partners, and inspiring care partner commitment to our mission, vision, values, and safe care pledge.
- Maintain skills and knowledge within professional practice for self and for assigned care partners; able to step in and serve as backup to assigned care partners to cover staffing needs as necessary.
- COMMUNITY INVESTMENT | FINANCE
- Manage systems, processes, policies, and procedures that result in effective planning and administration of annual budget(s); productive, cost-efficient, and effective operations within assigned functional areas; and effective corrective actions for any operating expenses that deviate from budget.
- Perform other duties as assigned. Know fire, disaster, and safety procedures and regulations as pertain to the work area.
- Formal Education: Bachelor's degree required within a related field. Associates Degree (AA or AS) in a related field with two years supervisory or management experience may be substituted for Bachelor's Degree.
- Work experience: 3 years to < 5 years of experience in a related area with two of those years being supervisory or management experience. Hospital Facility and Provider Group Coding and/or billing experience preferred.
- Required Licenses, Certifications, Registrations: Current Sigma Six Green Belt certification or required within one (1) year of employment. AHIMA or AAPC Certified Coder, preferred.
Parrish Medical Center offers a comprehensive benefits package, including health, dental, and vision insurance, 403(b) retirement program, tuition reimbursement/educational assistance, EAP, flex spending, accident, critical, and other applicable benefits. Eligible to participate in a number of PMC-sponsored benefits.
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