Supervisor Revenue Integrity - HIM Revenue Integrity

UNC Health • Chapel Hill, NC

6d • Remote

About The Position

The Supervisor of Revenue Integrity oversees staff and the daily operational processes of the UNC Health Care System Revenue Integrity Program. The role ensures work is performed efficiently and with high quality to meet service-level agreement expectations and regulatory standards. It supervises revenue integrity workflows, supports team members with appropriate tools and training, collaborates on billing and compliance matters, and works with revenue cycle and clinical partners to identify and prevent charging issues.

Requirements

• Bachelor's degree in a related field, or an equivalent combination of education, training, and experience.
• With a bachelor's degree: two years of relevant experience and one year of supervisory or team lead experience.
• With an associate's degree: six years of relevant experience and one year of supervisory or team lead experience.
• With a high school diploma or GED: ten years of relevant experience and one year of supervisory or team lead experience.
• Ability to research complex coding and regulatory requirements and analyze payer regulations and coding guidelines.
• Extensive knowledge of Correct Coding Initiative (CCI) edits, CPT, HCPCS, ICD, revenue codes, modifiers, billing, and Medicare, Medicaid, and third-party billing rules, coverage, payment, and compliance requirements.
• Ability to meet deadlines in a fast-paced, dynamic, project-oriented environment, with strong time management and prioritization skills.
• Self-motivated and detail-oriented, with strong analytical and critical-thinking skills.
• Effective verbal and written communication skills, including the ability to present information professionally to all levels of management.
• Understanding of overall hospital revenue cycle functions.
• No licensure or certification is required.

Responsibilities

• Oversee daily processes for charge capture and review, DNB edits, CCI/OCE and other pre- and post-bill edit processing, OBSV review and carve-outs, Infusion & Injection, and ED Charge Review through effective staffing plans and work assignments.
• Drive operational workflows and meet established quality and productivity goals while seeking improvements to the efficiency and accuracy of direct and indirect work functions across the health care system.
• Provide team members with the tools and training needed to meet operational goals.
• Advise and collaborate with the Compliance Office, Internal Audit, legal counsel, and outside consultants to analyze, review, and assess billing, coding, charging, and compliance issues.
• Engage Revenue Cycle leaders, Clinical Liaisons, and other team members to identify opportunities to prevent missed charges and incorrectly charged services, and provide education on changes in charge practices and medical necessity in accordance with local and national guidelines.

What This Job Offers

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