Manager Revenue Integrity

OverviewFairview is looking for a Manager Revenue Integrity to join our team. Job Summary:The Manager Revenue Integrity is responsible for the leadership, development, coordination, implementation, and oversight of one or more Revenue Integrity team functions. These functions aim to support the organization with revenue and charging related questions as well as proper research and setup of charge processes and pricing to ensure accurate, timely charging. This role works cross functionally across the continuum of Revenue Cycle and maintains knowledge of charging workflows within the EHR, including its various application and software's. The manager of Revenue Integrity completes metrics reporting as required and collaborates with IT in maintaining system applications. This role partners cross functionally with clinical and revenue cycle operational departments to achieve optimal system performance.About Fairview Fairview Health Services is an industry-leading, award-winning nonprofit that offers an entire network of healthcare services. Fairview is one part of M Health Fairview, a partnership between the University of Minnesota, M Physicians and Fairview Health Services. Together, we combine the University's deep history of clinical innovation and training with Fairview's extensive roots in community medicine. Our care portfolio includes community hospitals, academic hospitals, primary and specialty care clinics, senior facilities, facilitated living centers, rehabilitation centers, home health care services, counseling, pharmacies, and benefit management services. Apply today to join our 34,000+ employees and 5,000+ system providers working to build lasting relationships with the people we serve: our patients, our communities, and each other. Responsibilities Job DescriptionJob Expectations:Directs OperationsSets, oversees, and ensures daily operations, service support and outcomes are performed timely and accurately in accordance with regulatory and payer requirements.Ensures work assignments are performed and supported to achieve departmental goals and outcomesEnsures continuous improvement in people, process and technology related to charging creating maximum efficiencyTrack and assess integrity risks, and ensure the revenue integrity program is responsive to those risks, activates additional financial controls as appropriate and follow through to resolutionLead the enhancement of charge description master (CDM) activities and support maintenance of integrated revenue cycle applications, reviewing and optimizing organizational CDM structures to ensure all services and supplies are reflected accurately and are consistent with current industry best practices. Include clearly stated service level agreements and accountability for updates by all stakeholdersLead andor actively participate in committees addressing andor responsible for revenue integrity activitiesSets metrics and works to achieve industry level benchmarks for department and team.Selects, hires, orients, and trains qualified employees to perform job responsibilities, mentor and evaluate staffProvide routine performance reports regarding the nature, progress and status of the revenue integrity program, any course correction being taken, and any recommended changesEnsure staff members are knowledgeable about revenue assurance needs and reimbursement issues identified through audits, reviews, and aggregate data analysis. Designs and helps maintain workflows to ensure efficient and effective processesDevelops and implements key productivity and quality standards for department processesMonitors and prioritizes work based on organizational needs and assignments, appropriately assure timely, productive, and efficient use of resourcesProvides technical expertise, troubleshooting issues, and input on improvement projects and product selectionIdentifies, evaluates, coordinates and implements tactics to achieve organizational objectives, improve operational efficiencies, and increase positive cash flowFosters a culture of improvement, efficiency and innovative thinkingMaintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards.Provides oversight to assure compliance with established laws, regulations, practices, and procedures.Responsible for providing the operational oversight for system wide charge capture activities.Provides operation direction for Charge Capture Integrity, aligning direction with customer expectations, financial expectations, environmental requirements, and organizational objectives. This includes:The analysis of department charges, The identification and implementation of charge improvement strategies Assisting departments with their charge capture activities including the development of charge reconciliation processes where needed. Develop and implement a formalized system-wide charge capture education plan including execution strategy and routine updates as needed Monitoring, evaluation, and management of Department Budget by RCM leadership to achieve budgetRevenue Cycle Budgets - create Yearly Budget; Maintain and review monthly BudgetPerforms the duties as assignedDevelops Strong Work RelationshipsLeads or participates in in work with peers and other departments to create an excellent understanding of workflows and interdependencies, and to identify and implement strategies to improve revenue cycle performanceWorks collaboratively with vendors to assure performance expectations are being metRepresent Revenue Cycle and Fairview Health Services at industry forums to network and identify process improvement opportunitiesServes as a resource on revenue cycle issues and regulatory expectationsCreates strong collaborative partnerships and influence others across teams, groups and business boundaries to achieve real world problem solvingSkills, Abilities and Organization Expectations: Thorough knowledge of functions assignedThorough knowledge of computer systems used by assigned revenue cycle teamKnowledge of applicable regulatory requirementsKnowledge and understanding of hospital revenue cycle operations (registration, charge capture, health information management, claims, payment posting) Ability to present to small and large groupsConsistent demonstration of excellent written and verbal communication skillsProficiency in Microsoft Office: Word, Excel, Power-Point, Visio, Teams, SharePoint and Outlook.Performance improvement, project management andor lean skills QualificationsRequired QualificationsEducationBachelor's degree in business administration, Health Care Administration or related area PLUS 2 years of experience in health care reimbursement, financial management or coding OR an approved equivalent combination of education and experienceExperience3 years of applicable leadership business-related experienceLicenseCertificationRegistrationOne or more of the following: RHIA, RHIT, CHRI, CCS, , CPC, CCS-P, RN,OREpic Resolute Certification(s) in one or more of the following Epic applications: Resolute Professional Billing, Resolute Hospital Billing, Claims, completed within 1 year of employment.Preferred QualificationsEducationBachelor's Degree in Business Administration, Health Care Administration, Nursing, Education or related areaExperience5 years' experience in coding, clinical documentation improvement (CDI) professional revenue integrity, quality, or a directly related functional area of work LicenseCertificationRegistrationOne or more of the following: RHIA, RHIT, CHRI, CCS, CPC, CCS-P, RN, ANDEpic Resolute Certification(s) in one or more of the following Epic applications: Resolute Professional Billing, Resolute Hospital Billing, ClaimsEEO StatementEEOAA EmployerVetDisabled: All qualified applicants will receive consideration without regard to any lawfully protected status Benefit OverviewFairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: DisclaimerThe posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical.

Created: 2025-02-14