Manager, Revenue Integrity

The Menninger Clinic•Houston, TX

3d•Onsite

About The Position

The Revenue Integrity Manager oversees all aspects of the revenue cycle, including billing, collections, utilization review, coding, compliance, financial counseling, analysis, and team leadership. The Manager leads revenue cycle initiatives and supports optimization and operational use of the newly implemented Cerner electronic health record. The role also leads other projects as required.

Requirements

Bachelor’s degree in healthcare administration, a clinical discipline, or equivalent.
Seven years of experience in healthcare revenue cycle activities, including at least two years in hospital revenue cycle supervision or management.
Proficiency in billing, coding, and collections.
Strong micro-computer skills.
Ability to multitask and provide excellent customer service.
Knowledge of hospital billing cycle processes.

Nice To Haves

Certification from AHIMA or AAPC.

Responsibilities

Manage revenue integrity from charge capture through final bill collection, leading the team efficiently and compliantly.
Oversee and manage the Charge Master and pricing.
Develop and oversee processes for charge capture, coding, chart audits, and charge corrections; oversee provider education on coding and documentation.
Oversee day-to-day revenue cycle operations, including accounts receivable, aging, collections, billing and coding, utilization review and appeals, contractual adjustments, denial management, and customer service.
Monitor accounts receivable activity to ensure aging remains within company targets.
Ensure demographic information is accurate and complete.
Develop and adhere to revenue cycle policies and procedures.
Participate in strategic projects involving contract management with insurance companies and corporate clients.
Oversee insurance verification and authorization, reimbursement monitoring and interpretation, insurance company inquiries, claim tracking, denial management, and patient inquiries.
Lead business development activities in support of an evolving revenue cycle department.
Participate in PDSA cycles and project management related to revenue cycle improvements.
Implement procedures that support optimum reimbursement and regulatory compliance.
Develop and manage department key performance indicators and produce management reports supporting revenue integrity.
Analyze and interpret advanced reporting to support revenue enhancement and process efficiency.
Participate in the AHA survey as needed and in the annual financial statement audit.
Hire, manage, train, and evaluate professional-level staff.
Develop, implement, and monitor practices that comply with company policies and procedures.
Perform other duties as assigned.