Manager Revenue Integrity

Cooper University Hospital•Camden, NJ

20h

About The Position

The Manager of Revenue Integrity responsibilities are to ensure that all services are accurately charged by maintaining the chargemaster. To also ensure that the hospital is compliant with government regulations for pricing and that the organization receives accurate reimbursement. In addition, they are to work closely with department leaders to validate charges, reduce denials and develop missing charge capture strategies. Reporting to this position will be a Chargemaster Analyst who will help to maintain the chargemaster, research coding and billing guidelines, research insurance contracts and assist in updating the chargemaster. They will also perform audits to monitor compliance with corporate, federal and state guidelines. All results will be reviewed by this manager position. In addition, the Nurse Auditor and a Specialist will report up to this manager position.

Requirements

5+ years' experience overseeing the functionality of the CDM.
BS/BA required.

Responsibilities

Ensure that all services are accurately charged by maintaining the chargemaster.
Ensure that the hospital is compliant with government regulations for pricing and that the organization receives accurate reimbursement.
Work closely with department leaders to validate charges, reduce denials and develop missing charge capture strategies.
Maintain the chargemaster.
Research coding and billing guidelines.
Research insurance contracts and assist in updating the chargemaster.
Perform audits to monitor compliance with corporate, federal and state guidelines.
Coordinate a robust charge reconciliation process with department or service line leaders.
Keep abreast of coding and reimbursement changes to ensure maximization of reimbursement and reduction of denials for coding errors by maintaining an accurate chargemaster.
Manage the Chargemaster Analyst or equivalent directly for chargemaster maintainer.
Manage the Charge Auditor function to close gaps in missing charges.
Initiate process improvement objectives to reduce missing charges and ensure completeness of Revenue Integrity.
Collaborate with Informatics and IT resources to ensure upstream processes to ensure complete charging.
Collaborate with Supply Chain to ensure that new supplies, drugs and implants are being charged for correctly.
Collaborate with decision support to ensure that charging is in line with organizational goals.
Contribute to monthly Revenue Cycle meetings to report on revenue Integrity functions.
Collaborate with other Revenue Cycle leaders to develop denial reduction and missing charge capture strategies.
Make recommendations for products and services that can improve our performance.
Other duties as assigned.