Mgr, Rev Integrity Operations

Orlando Health•Orlando, FL

About The Position

At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida’s east to west coasts and beyond. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin benefits on day one and offer flexibility wherever possible so that you can be present for your passions. “Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you. Position Summary: The Revenue Integrity Operations Manager is responsible for overseeing the accuracy and compliance of a healthcare organization’s revenue cycle. The Mgr, RIO will identify revenue opportunities and ensure the ongoing monitoring of Medicare and other Payer regulatory compliance changes. This role involves leading a team of various positions including Assistant Managers, Liaisons, and Coordinators.

Requirements

Bachelor’s degree in business administration, finance, computer science or healthcare related field.
Associate’s degree and two (2) years of directly related work experience may substitute for bachelor’s degree in addition to required experience.
5 years of experience working within a revenue cycle department in a hospital.
2 years of managerial experience including team building strategies or process development.
Knowledge of Medicare, Medicaid, Medicare OPPS reimbursement and other third-party billing rules and coverage.
Have excellent regulatory resource capabilities.

Nice To Haves

Coding certification or healthcare related license.

Responsibilities

Assigns and monitors staff workload to ensure goals are met on time and within budget and regulatory guidelines through approved methods and standards.
Assists in annual budget projection and works within finalized budget and capital approvals.
Provides resources as appropriate to assist other areas in the Revenue Cycle to complete projects.
Delegates special projects providing realistic goals, timelines, resources, and adjusting for unforeseen opportunities.
Establish guidelines for process improvements to ensure stages are documented, approved, communicated, and implemented.
Ensure delivery of Executive Summaries to all appropriate parties in the revenue cycle team.
Provides clear vision, direction, planning, and support to direct reports.
Collaborate with all team members, Site Administration, CFO’s and Managers within all revenue producing departments.
Recruits and retains qualified staff members to ensure visibility of the department at all locations.
Provides mentoring and career development to direct and/or indirect reports within the Revenue Integrity Department.
Encourages direct reports to work collaboratively with IS, Nursing and Revenue Management leadership in the process improvement and implementation of charge capture opportunities.
Develops relationships with various committees and groups to ensure continuity in processes that increase revenue capture.
Communicates and interfaces professionally with other Managers and team members in the Revenue Integrity Department.
Identifies communication opportunities to minimize overlap of processes and enhance workflow.
Empowers team and build trust by leading through integrity, impartiality, and responsiveness.
Trains team to assist departments on daily charge capture, and reconciliation processes.
Oversee all pricing and compliance methodologies are applied to charges according to regulations and corporate financial guidelines.
Oversee the Education and Training, as it pertains to the revenue cycle, charge capture, and analytics.
Reports capture successes as they occur in entering areas.
Directs an annual review of departments whose charges are grouped by APC, relative weight or any other level assignment to ensure validity of charging practices.
Ensure revenue neutrality is maintained through performance of a gross/net revenue impact analysis on any change in charging practices.
Responsible for communicating process changes to all appropriate staff members in a timely manner to avoid confusion.
Oversees implementation of all regulatory alerts, updates and Chargemaster changes.
Ensure direct reports grasp the impact of changes, expected outcomes, and follow necessary steps in management revenue processes.
Prepare revenue dashboards and reports for various audiences and updates as needed.
Manages various human resources functions including hiring, work assignments, coaching, training and development, and performance improvement plans.
Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
Maintains compliance with all Orlando Health policies and procedures.
Maintain policies, procedures, and SOP manuals as appropriate.
Ensures quality assurance processes are implemented and monitored for all areas of responsibility.
Other duties as assigned.