Manager Revenue Integrity

UT Southwestern Medical Center • Dallas, TX

7h • Onsite

About The Position

The Revenue Integrity manager provides management planning, development and guidance to staff within the roles of Audit and Chargemaster. Analyze data and develops an overall approach for trending issues, report findings, applying timely and constructive feedback, continued education and training (as the "content experts") for Revenue Integrity, clinical departments, nursing units/depts. Prepares departments summaries based upon audit findings and works closely with applicable staff/management for continued performance improvement ensure compliance with Medicare/Medicaid regulations, Managed Care contractual agreements and the applicable policies of UT Southwestern University Hospital.

Requirements

• Bachelor's Degree from a recognized college or university in business, healthcare or a closely related field or 10 years' of experience within the revenue cycle and coding.
• 10 years Experience in the hospital setting, healthcare industry or coding with a focus in one or more of the following areas: coding, charge integrity; charge reconciliation; charge compliance; charge auditing; CDM management or Audit Nursing
• 1 year Supervisory experience
• (RN) REGISTERED NURSE or
• (CPHT) CERT PHARMACY TECH or
• (PTCB) CERT COMPND STERILE PREP TECHN or
• (CHRI) CertHealthcareRevenueIntegrity professional certification through NAHRI or
• (RHIA) REGD HEALTH INFO ADMINIST professional certification through AHIMA or
• (RHIT) REGD HEALTH INFO TECHNOLO professional certification through AHIMA or
• (CCS) CERT CODING SPECIALIST professional certification through AHIMA or
• (COC) Certified Outpatient Coding professional certification through AAPC or
• (CPC) CERT PROFESSIONAL CODER professional certification through AAPC

Nice To Haves

• EPIC HB/PB experience, Project Management and Six Sigma Green Belt knowledge/experience

Responsibilities

• Oversees all revenue integrity staff with a focus on charge capture and charge reconciliation activities.
• Coordinates efforts with Sr. Nurse Auditor and Sr. Chargemaster Coordinator to lead audit/ charge evaluations according to RI auditing guidelines.
• Meets with departmental leadership to review findings, documentation standards and recommendations for improvement.
• Analyzes charge capture audit reports to verify that appropriate charges have been posted to patient accounts according to diagnosis and related procedure codes and that revenue has been routed/recorded in the appropriate department/cost center.
• Coordinates efforts with Sr. Nurse Auditor and Sr. Chargemaster coordinator to insure all staff are informed of all regulatory changes for both hospital billing and professional billing, conduct any necessary training and all policies are kept up to date assists departments with the charge reconciliation process.
• Works with all relevant hospital departments and professional billing departments to provide timely education on how to correct or improve processes that have been found to be deficient.
• Advises service line leaders and their staff on proper usage of charge codes; identifies opportunities for capturing additional revenue in accordance with payer guidelines; develops specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections for both hospital and professional billing.
• Stay abreast of ongoing compliance trends and developments.
• Reports new developments to department.
• Plans and presents in-services to nursing, physician, and other clinical personnel regarding processes, updates and reviews relating to audit findings and/or regulatory compliance.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100%25 coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer

What This Job Offers

• Job Type: Full-time
• Career Level: Manager