Revenue Integrity Manager - FT - Days - MHS

Memorial Healthcare • Rockville, MD

86d

About The Position

The Manager of Revenue Integrity is responsible for overseeing the daily operations, performance, configuration, and development of assigned applications to ensure alignment with departmental goals and objectives. This role manages a team of Revenue Integrity Analysts who provide technical expertise to support charge capture processes, system functionality, and compliance requirements. The Manager also designs, implements, and tests controls to optimize revenue capture, enhance net revenue, and ensure regulatory compliance across people, processes, and technology.

Requirements

• Associates degree required; Bachelor's preferred.
• Epic Charge Router Certification (EPIC).
• Epic Resolute Billing Certification (EPIC).
• Minimum of five (5) years' Epic charge master and/or billing experience.
• Minimum of three (3) years’ experience of supervising/managing a team.
• Candidate must have or be pursuing a coding credential (AHIMA or AAPC) which must be obtained within a year of taking the position.

Responsibilities

• Manages the planning of application development and deployment; educates and promotes adherence to the organization's software compliance standards within the team.
• Identifies and achieves opportunities to improve charge capture efficiency and accuracy, eliminate missed charges, eliminate billing rework, and improve MHS net revenue.
• Keeps current, timely reads, and analyzes Medicare, Medicaid, and other technical guidance to determine how they affect Memorial Healthcare System (MHS) capture.
• Develops, recommends, and implements plans to comply with regulatory updates as approved by the Director of Revenue Integrity.
• Develops annual CDM CPT/HCPCS updates and implements as approved by the Director of Revenue Integrity.
• Oversees the maintenance of CDM-driven CPT/HCPCS coding requirements.
• Develops annual CDM Fee Schedule updates and implements as approved by the Director of Revenue Integrity.
• Updates Price Transparency Standard Charges file in accordance with regulatory requirements.
• Manages and monitors staffing activities including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.
• Tests samples of departmental charges to evaluate whether staff members are performing correctly.
• Monitors and provides training, support and troubleshooting to both application teams and end-users.
• Manages applications projects including workflow analysis, end-user validation, acceptance, go-live, and maintenance.
• Utilizes subject matter expert skills to assist MHS leaders with analyses of billing, coding, and documentation requirements.
• Designs and evaluates the tools and processes used to capture charges in each MHS department.
• Ensures Epic charge-related work queues are timely and correctly cleared.
• Selects opportunities identified by team to implement and improve existing processes using information technology.

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees