REVENUE INTEGRITY MANAGER, REVENUE INTEGRITY

Description

Location: SGMC Patient Financial Services

Department: REVENUE INTEGRITY

Schedule: Full Time, 8 HR Day Shift, 8:00am - 5:00pm

Position Summary

In collaboration with the Revenue Integrity Director, the Revenue Integrity Manager oversees and optimizes revenue cycle processes within our healthcare organization to ensure accurate billing, coding, and compliance with regulations, maximizing revenue and minimizing financial losses.

EDUCATION

• Bachelor’s degree from an accredited college in a healthcare discipline or five (5) years experience in a related field
• CPC, CCS, COC, RHIT or other coding certification preferred
  
  

Experience

• Minimum three (3) years of CDM experience
• Strong coding background/knowledge required.
• EPIC experience required.
  
  

KNOWLEDGE, SKILLS & ABILITIES

• Knowledge of facility charge master principles and the relationship to coding, billing, reimbursement and compliance in a hospital or health system setting.
• Working knowledge of CPT/HCPCS coding, CMS regulations, and UB Revenue Codes required.
• Strong communication, interpersonal, and rapport-building skills.
• Strong analytical skills and problem-solving skills.
• Analyze data, identify trends, and develop solutions to improve revenue integrity.
• Knowledge of healthcare regulations and compliance, including current billing, coding, and compliance regulations.
• Familiarity with billing, coding, claims submission, and other revenue cycle functions.
• Effectively supervise and mentor staff, manage projects, and drive improvement initiatives.
• Effectively communicate with stakeholders, including clinicians, billing staff, and leadership.
• Excellent oral and written communication skills including the ability to teach complex technical / analytical concepts to SGMC Health leaders and team members.
• Ability to manage large, complex, simultaneous assignments with potentially conflicting priorities and deadlines.
• Proficient in relevant software and systems used for revenue cycle management. This may include Microsoft Office applications (Excel, Word, PowerPoint), EPIC, Craneware, and third-party clinical interface applications.
  
  

WORKING CONDITIONS - ADA INFORMATION

Modern, well-lighted, air-conditioned, general office area and clinical areas with revenue generating departments. Moderate/high stress level. Ability to sit, stand, or walk for moderate periods. Moderate heavy lifting (0-25 pounds), reaching, stooping, pushing, pulling, bending, and twisting.