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Coding and Revenue Integrity Manager
Coding and Revenue Integrity ManagerSolaris Health Holdings • Fort Lauderdale, FL, US
Coding and Revenue Integrity Manager

Coding and Revenue Integrity Manager

Solaris Health Holdings • Fort Lauderdale, FL, US
[job_card.variable_days_ago]
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  • [job_card.full_time]
[job_card.job_description]

Job Description

Job Description

Description :

NO WEEKENDS, NO EVENINGS, NO HOLIDAYS

We offer competitive pay as well as PTO, Holiday pay, and comprehensive benefits package!

Benefits :

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life Insurance
  • Pet Insurance
  • Health savings account
  • Paid sick time
  • Paid time off
  • Paid holidays
  • Profit sharing
  • Retirement plan

GENERAL SUMMARY

The Coding and Revenue Integrity Manager has oversight of the revenue generating and coding processes and outcomes for designated Affiliate(s). They are responsible for maintaining a strategic and leadership role for improving revenue results through oversight of administrative and financial processes to ensure claims are submitted timely and accurately as well as developing a centralized coding and charge reconciliation team to reduce duplication and streamline charge capture and coding functions. This manager ensures coding accuracy by facilitating coder education on current and compliant coding guidelines. They support the planning, development, and administration of the coding quality assurance function and the designing of a Provider Documentation Education program to provide focused education to clinical and coding resources.

Requirements :

ESSENTIAL JOB FUNCTION / COMPETENCIES

The responsibilities and duties described in this job description are intended to provide a general overview of the position. Duties may vary depending on the specific needs of the affiliate or location you are working at and / or state requirements. Responsibilities include but are not limited to :

  • Supports the Regional Senior Director of RCM in related strategy development, planning, and execution of the Revenue Integrity and Coding functions.
  • Implements quality measures based on Physician captured charges, coding, and patient care documentation to ensure compliance with pertinent regulations, guidelines, and industry benchmarks.
  • Establishes routine charge capture and coding audits and create feedback process to ensure continuous improvement.
  • Oversees the training, monitoring, and management of coding and charge capture.
  • Develops, reviews, and maintains policies and procedures for Revenue Integrity.
  • Ensures the placement of controls holding providers and practice locations accountable for effectively managing the coding denial management and charge capture processes.
  • Tracks and trends Key Performance Indicators (KPIs) to measure outcomes and document improved performance.
  • Oversees data analysis, trending, and reporting of opportunities for improvement in the charge capture and documentation functions.
  • Ensures adequate training and education is provided to providers and practice staff regarding accurate charge selection / entry and documentation requirements.
  • Performs other position related duties as assigned.
  • Employees shall adhere to high standards of ethical conduct and will comply with and assist in complying with all applicable laws and regulations. This will include and not be limited to following the Solaris Health Code of Conduct and all Solaris Health and Affiliated Practice policies and procedures; maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA); immediately reporting any suspected concerns and / or violations to a supervisor and / or the Compliance Department; and the timely completion the Annual Compliance Training.

    • CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS

  • CPC, RHIT, CCS, OR CMC coding credentials preferred.

    • KNOWLEDGE | SKILLS | ABILITIES

  • Demonstrates understanding of business and how actions contribute to company performance.
  • Excellent customer service, verbal, and written communication skills.
  • Knowledge of medical terminology, Current Procedural Terminology (CPT), International Classification of Disease (ICD) coding, and the entire revenue cycle process.
  • Familiarity with Electronic Health Record (EHR) systems and Microsoft Office applications.
  • Understanding of Medicare, Medicaid, managed care, and third-party payer guidelines.
  • Knowledge of governmental regulations and healthcare compliance requirements.
  • Strong analytical and problem-solving skills with the ability to draw conclusions and make recommendations.
  • Ability to handle multiple tasks and manage competing deadlines with a high level of accuracy and attention to detail.
  • Capable of developing reports and creating professional presentations.
  • Well-organized and able to maintain confidentiality in handling sensitive information.
  • Ability to educate staff members.
  • Self-motivated with a focus on maintaining productivity and efficiency.
  • Ability to work independently and collaboratively across teams and departments.
  • Skill in planning, organizing, delegating, and supervising.
  • Skill in leading team members to carry out all job objectives while inspiring confidence and motivation.
  • Skill in organizing work, tasking assignments, and achieving goals and objectives.
  • Ability to establish and maintain quality control standards.
  • Ability to assume responsibility and exercise authority over assigned work functions.

    • EDUCATION REQUIREMENTS

  • High School Diploma or equivalent required.
  • Associates level or higher preferred.

    • EXPERIENCE REQUIREMENTS

  • Minimum of five-eight years revenue cycle experience within a physician practice.
  • Experience in Urology physician practice environment preferred.

    • REQUIRED TRAVEL

  • N / A

    • PHYSICAL DEMANDS

    Carrying Weight Frequency

    1-25 lbs. Frequent from 34% to 66%

    26-50 lbs. Occasionally from 2% to 33%

    Pushing / Pulling Frequency

    1-25 lbs. Seldom, up to 2%

    100 + lbs. Seldom, up to 2%

    Lifting - Height, Weight Frequency

    Floor to Chest, 1 -25 lbs. Occasional : from 2% to 33%

    Floor to Chest, 26-50 lbs. Seldom : up to 2%

    Floor to Waist, 1-25 lbs. Occasional : from 2% to 33%

    Floor to Waist, 26-50 lbs. Seldom : up to 2%

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