Revenue Integrity Manager - FT - Days - MHS

Manager Of Revenue Integrity

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.

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.

Responsibilities include managing the planning of application development and deployment; educating and promoting adherence to the organizations software compliance standards within the team. Strategic focus includes identifying and achieving opportunities to improve charge capture efficiency and accuracy, eliminate missed charges, eliminate billing rework, and improve net revenue. Keeps current with 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 and in collaboration with responsible MHS leaders. Manages and monitors staffing activities including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives. Periodically tests samples of departmental charges to ensure staff members are performing correctly, and controls are operating as designed. Works with RCM and departmental staff to provide as-needed retraining as well as regular periodic updates for all charge capture staff. Monitors and provides training, support, and troubleshooting to both application teams and end-users to facilitate proper usage and continuous learning. Manages applications projects including workflow analysis, end-user validation, acceptance, go-live, and maintenance using standard project management methodology. Sets project deadlines and deliverables for specific modules and analysis. Manages the debugging and enhancements processes including the design and upgrades to existing systems in order to ensure up-to-date and reliable functionality. Utilizes subject matter expert skills to assist MHS leaders with analyses of billing, coding, and documentation requirements for payer coverage and payment of services affecting their service lines and initiatives. Designs and evaluates the tools and processes used to capture charges in each MHS department. Updates the design of tools to empower departmental staff to accurately post charges efficiently, without rework. Designs and implements controls to empower departmental leaders to ensure staff have captured charges accurately and timely. 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 and ensures alignment with strategic initiatives of the organization.

Competencies include accountability, accuracy, analysis and decision making, customer service, develops relationships, effective communication, organization skills, productivity, responding to change, standards of behavior, teamwork.

Education and Certification Requirements : Associates (Required) Epic Charge Router Certification (EPIC CHG ROUTER) - EPIC Certification (EPIC), Epic Resolute Billing Certification (EPIC BILLING) - EPIC Certification (EPIC).

Additional Job Information : Complexity of Work : Requires critical thinking skills, effective communication skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Required Work Experience : Minimum of five (5) years Epic charge master (preferred) and / or billing experience. Able to build charge records (EAP) and controls (charge router, charge handler, and revenue guardian). Minimum of three (3) years experience of supervising / managing a team. Other Information : Additional Education Info : Associates degree required; Bachelors preferred. Certification Requirements : Epic Resolute Billing Certification, Epic Charge Router Certification. Candidate must have or be pursuing a coding credential (AHIMA or AAPC) which must be obtained within a year of taking the position.

Working Conditions and Physical Requirements include bending and stooping, climbing, keyboard entry, kneeling, lifting / carrying patients 35 pounds or greater, lifting or carrying 0 - 25 lbs non-patient, lifting or carrying 2501 lbs - 75 lbs non-patient, lifting or carrying >

75 lbs non-patient, pushing or pulling 0 - 25 lbs non-patient, pushing or pulling 26 - 75 lbs non-patient, pushing or pulling >

75 lbs non-patient, reaching, repetitive movement hand / arm, sitting, squatting, standing, walking, audible speech, hearing acuity, depth perception, distinguish color, seeing - far, seeing - near, bio hazardous waste, biological hazards - respiratory, biological hazards - skin or ingestion, blood and / or bodily fluids, communicable diseases and / or pathogens, cytotoxic chemicals, dust, gas / vapors / fumes, hazardous chemicals, hazardous medication, latex, computer monitor, domestic animals, hazardous noise, magnetic fields, moving mechanical parts, potential electric shock, radiation, wet or slippery surfaces.