Program Manager - Revenue Integrity

UHS•Tredyffrin Township, PA

15h•Onsite

About The Position

The Corporate Revenue Cycle Department is seeking a dynamic and talented Program Manager - Revenue Cycle - Revenue Integrity. As a Revenue Cycle Program Manager, you’ll be responsible for assessing current revenue cycle processes and workflows; identifying areas for efficiency and effectiveness enhancements, collaborating with teams (e.g., registration, billing, charging, coding, collections, and denials management) to streamline processes, reduce and recover denials, and optimize cash flow; and analyzing and monitoring revenue cycle metrics to identify trends, variances, and opportunities for improvement. Revenue Cycle Program Managers are experts in the subject matter and possess a comprehensive understanding of Revenue Cycle operations. Program Managers operate independently to analyzes accounts receivable and ensure maximization of net revenue realization, stable cash collections, avoidance of denials and measured reduction to bad debt. Program Managers act as liaisons between central billing offices, facilities, and other stakeholders. The Revenue Integrity Program Manager serves as a leader and subject matter expert for revenue integrity operations by optimizing revenue, supporting clinical and other colleagues in optimizing accurate charge capture, interpreting government regulations and payer requirements, and maintaining the chargemaster. The Revenue Integrity Program Manager oversees projects, implements best practices, educates users on processes and vendor products, and recommends actionable improvements. Revenue Integrity Program Managers also serve as a liaison to the Central Business Offices and facilities to support continuous process improvement and compliant revenue maximization.

Requirements

A minimum of 8-10 years of relevant experience
A college degree in business, finance, healthcare administration, health information management, or similar
Demonstrated experience working in a patient accounting system
Coordinating diverse stakeholders
Improving Revenue Cycle operations
Utilizing pattern analytics and industry best practices to enhance systems and operations
Experience with healthcare compliance
Health information experience
Inpatient medical billing and coding experience
Healthcare regulatory operations experience
Strong professional written and verbal communication skills
Proficiencies in Microsoft Office tools (e.g., Word, Excel, etc.)
Ability to meet deadlines and multitask

Nice To Haves

Medical coding certification (e.g., CPC, CCS) is strongly preferred
Significant Revenue Cycle experience (i.e., 5+ years in addition to the minimum) might be accepted in lieu of certain college education requirements.

Responsibilities

Monitors, reads, interprets, and disseminates regulatory and payer requirements to identified parties timely through the creation of communications, trainings, and policies
Performs and/or coordinates revenue integrity audits to verify adherence to policy, regulatory guidance and industry standards, analyzes audit findings to create action plans, and coordinates efforts for remediation as needed
Supports the implementation and maintenance of revenue cycle management software and tools based on end user requests and regulatory guidance
Communicates CDM maintenance activities to clinical departments and information systems staff to implement necessary changes that affect charge identification, capture, reconciliation, and claim processing
Responds to internal and external audit requests in a timely manner
Provide guidance, coaching, and mentorship to junior team members
Generates reports related to revenue cycle metrics, such as CDM accuracy, charge capture, claim denials, write-offs, and payment delays, and assist in analyzing trends
Performs all other duties as assigned/required