Revenue Integrity Supervisor (Remote Possible)

Approved Remote States
1. Arizona
2. Florida
3. Georgia
4. Idaho
5. Indiana
6. Iowa
7. Maine
8. Michigan
9. South Dakota
10. Texas
11. South Carolina
12. North Dakota
13. Wisconsin
14. Tennessee
Position Summary:
The Revenue Integrity Supervisor assists the System Manager of Revenue Integrity (RI) with planning, directing, organizing, monitoring, and staffing departmental services subject to policies, budgets, objectives, and directives mandated by regulatory agencies, DNV, and the executive team. Supports the revenue for the health system by maintaining a compliant and defensible Charge Master (CDM), claim integrity, and charger reconciliation program. Assists with departmental and organizational training and education to promote the overall integrity of the CDM program. Works closely with other organizational functions as directed and in collaboration with the RI Manager.
Minimum Qualifications:

• Associate's degree in Business or Accounting; an equivalent combination of education and experience will be considered
• Three (3) years of experience in a ChargeMaster role or Healthcare Charge Equivalent
• Three (3) years of supervisory experience
• Prior experience with Epic
• Regulatory knowledge required for PPS and CAH Hospital, Provider-Based, Free-Standing Clinic, Swing Bed Billing, and Payer Enrollment
• Preferred: Bachelor's degree in business or related field
• Preferred: Working knowledge of Coding and Payment Classification Systems, i.e. ICD-10, HCPCs, CPT, OPPS, IPPS, MPFS
• Preferred: Three (3) years of experience in ChargeMaster role
• Preferred: Coding Certificate; Certified Provider Credentialing Specialist (CPCS)

Essential Job Functions:

• Assists leadership with broad operations to ensure the provision of comprehensive departmental services in compliance with all regulatory agencies and hospital requirements
• Assists in the accurate development and submission of claims to support reimbursement, including timely filing requirements in collaboration with the RI Manager and other departments as directed
• Assists RI Manager in developing and monitoring key performance indicators, i.e., specific candidate for billing, revenue guardian edits, charge-related edits, accounts receivable days, and applicable WQs
• Assist RI Manager in report generation and analysis to identify root causes and develops solutions for issues identified.
• Assists RI Manager on accurate and timely CDM updates as required by annual CPT and BH budget requirements, i.e., price increase in collaboration with IT
• Assisted the RI Manager with the Revenue Reconciliation program for BH and was a member of the Revenue Reconciliation Committee.
• Assists staff in any data analysis projects or ad-hoc projects as directed by RI Manager
• Assists in internal quality monitoring programs of the CDM, including external reviews and internal monitoring, including the implementation of opportunities identified, as directed by the Manager of RI.
• Ensures requests to make changes or updates to the CDM are done accurately and timely
• Ensures payer enrollment is accurate and timely to avoid gaps in payer enrollment, i.e., facility and individual provider enrollment
• Leads, teaches, inspires, helps, and consistently demonstrates hospital behavioral standards.

Knowledge, Skills, and Abilities

• Strong leadership managerial skills; ability to plan, delegate, train, monitor and improve work performance
• Demonstrates ability to lead to and motivate staff
• Demonstrates sound judgement, patience, and maintains a professional demeanor at all times
• Ability to work in a busy and stressful environment
• Familiar with business and medical terminology, billing codes, and coding systems (ICD-10, HCPCS, CPT)
• Strong interpersonal, organizational, multi-tasking, verbal and written communication skills
• Creativity, problem analysis and decision making
• Exercises tact, discretion, sensitivity and maintains confidentiality

• Detail oriented, organizational skills and the ability to prioritize
• Standard office equipment and computer applications; MS Office, internet applications and proficient in Epic.
• Ability to work varied shifts

The above statements are intended to describe the general nature and level of work being performed by people assigned to the job classification. They are not to be construed as a contract of any type nor an exhaustive list of all job duties performed by the personnel so classified.
77211370 Patient Financial Services