Manager Revenue Integrity RN

Rush University Medical Center•Chicago, IL

34d•$50 - $90•Onsite

About The Position

The Manager, Revenue Integrity RN will use collaboration, assessments, training skills, and clinical knowledge to ensure that patient charges are accurate while leading the team of nurses. This role will lead the nursing staff in their reviews charges and clinical documentation, initiates and leads performance improvement efforts, and educates clinical departments about charging while promoting revenue integrity. This nurse manager exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

Requirements

Current State of Illinois RN Licensure
Associates or Bachelor's degree in nursing
Coding credential from AAPC or AHIMA (CCS, CCA, CPC, COC, CPMA, RHIT or RHIA)
Epic Certification
2+ years of Revenue Integrity or Revenue Cycle experience
5+ years of clinical nursing experience using Epic software
Mathematical skills related to pharmaceutical dose and unit calculations
Understanding of clinical charging and the relationship to codes, edits, and proper charging
Demonstrated ability to communicate clearly and effectively
Strong interpersonal skills necessary for the communication and training of Revenue Integrity concepts
Ability to perform multiple tasks with excellent time management skills
Proficient in Microsoft Office, Excel, PowerPoint, and Word skills

Nice To Haves

Procedural nursing including Operating room, Labor and Delivery, Cath lab, Interventional Radiology, or Emergency Room

Responsibilities

Lead the team that connects the Clinical Operations knowledge and experience to Revenue Integrity, charge description master (CDM), charge capture and metrics to ensure accurate revenue and reimbursement
Improves revenue results by optimizing and improving the clinical, operational, and revenue integrity processes related to patient charges
Build relationships within the revenue cycle, and engage clinical areas of the organization that serve as mutually beneficial partnerships, providing support as a clinical and charging subject matter expert with billing, patient access, and third-party billing audits
Reviews CPT/HCPCS descriptions and charges with clinical documentation to ensure compliant charging
Identifies services performed in the clinical department for individual patients that need to be built in the Charge Description Master (CDM)or be charged on a patient's account based on CPT/HCPCS descriptions compared to clinical activities. Adjusts charges on patient accounts as needed.
Identifies chargeable supplies, implants, devices, and pharmaceuticals
Identifies and trouble-shoots charging, CDM, or clinical documentation issues and works with ancillary departments to resolve
Provides recommendations on cost-containment related to charges, for clinical areas
Contributes to internal controls to ensure compliance with charging regulations
Identifies patterns, trends, variances, and opportunities to improve charging accuracy
Engages clinical departments in revenue integrity; research code and charge questions as requested
Provides education to clinical departments to promote appropriate charge capture processes and documentation requirements for specific charge activity
Identify trends and lead performance improvement efforts through multi-disciplinary teams to streamline processes, enhance charging automation, train staff, and promote accuracy
Responsible for implementing short and long-term plans and objectives within set deadlines to ensure compliant coding practices, ensure claims timely filing, & reduce denials
Develop, update and implement job standards, job duties, job aids, departmental policies, and performance appraisals for all areas of responsibility. Engages in development and growth of self and the team
Collect, interpret, and communicate performance data using various tools and systems, while also using this data to make decisions on how to achieve performance and budgetary goals
Responsible for interviewing, hiring, orienting new team members (staff & temp), staffing, performance management and development of staff. Counsel and disciplines employees, when necessary, in accordance with department and/or organizational policies. Maintains staff schedules, timecards, and payroll with fiscal responsibility.
Prepares monthly analytics reports, dashboards information, and other statistics along with assisting in strategic planning
Facilitate a positive culture that exemplifies growth-minded practices, leadership, and industry-best practices