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Manager, Revenue Integrity (Professional)

Work Schedule/Days:  Day / Monday - Friday
Employment Type:  Full-Time
Location:  Support I 
Requisition #:  87861

 

JOB SUMMARY

Provides leadership for revenue integrity activities in support of the system's missions and values. Coordinates activities related to charging and revenue recognition throughout Children’s Healthcare of Atlanta entities. Optimizes processes that support accurate and complete capture of charges. Coordinates education of Revenue department leaders as to roles and responsibilities related to revenue capture. Supports Children’s Healthcare of Atlanta corporate compliance structure by verifying adherence to charging policies and procedures and ensures charge master is in compliance with applicable guidelines. Identifies and optimizes information system use, operational workflows, and processes that impact revenue capture and billing. Works closely with other Revenue Cycle directors/teams to identify and implement data quality efforts related to revenue generation. Maintains productive relationships with Revenue Cycle leaders and stakeholders throughout Children’s Healthcare of Atlanta, including physician practices, hospital operations, Finance, Reimbursement, Information Systems & Technology, Compliance, and others as appropriate. Proactively supports efforts that ensure delivery of safe patient care and services and promote compliance and revenue integrity at Children's Healthcare of Atlanta.

EDUCATION

  • Bachelor’s degree in Business Administration, Finance, or related field

CERTIFICATION SUMMARY

  • No professional certifications required

EXPERIENCE*

  • 5 years of experience in healthcare system finances, including revenue integrity, reimbursement, or charge master
  • Experience in assessing, analyzing, and developing reports with SQL or Access    
  • Experience in optimizing Epic revenue cycle applications 

PREFERRED QUALIFICATIONS*

  • Master’s degree
  • Epic certification
  • Experience in working with providers (e.g., physicians, advanced practitioners), clinical and service line leaders, and others who perform and/or impact revenue generation and recognition

KNOWLEDGE SKILLS & ABILITIES*

  • Demonstrated skills and working knowledge of charge master, reimbursement, and billing requirements 
  • Demonstrated communication, organizational, and interpersonal skills
  • Experience applying skills in conflict resolution, problem-solving, and staff development

JOB RESPONSIBILITIES*

  1. Provides strategic direction for revenue integrity functions, including accuracy and integrity of revenue capture systems across revenue-generating departments of Children’s Healthcare of Atlanta. 
  2. Works with service department operational and financial managers to develop and implement procedures for capturing and reconciling charges posted in the billing system.
  3. Identifies opportunities for charge capture improvement through reviews and random assessments.
  4. Seeks input from leaders of operational and finance departments impacted by the charge master.
  5. Reviews changes in pricing and CPT/HCPCS codes and acts as a resource to revenue-generating departments.
  6. Assesses changes in regulations and contracts that affect billing and compliance and educates impacted finance and operational leaders.
  7. Coordinates training related to charge master, revenue generation, charge reconciliation, and other topics that impact revenue recognition and compliance.   
  8. Responsible for all aspects of managing and leading a team including: interviewing, hiring, training, developing, directing work and processes, managing performance, recognizing, and rewarding employees.
  9. Mentor team members to encourage personal and professional growth.
  10. Encourage ongoing skill development by providing opportunities for continued education.

SYSTEM RESPONSIBILITIES*

Safety: Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system.

 

Compliance: Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Maintains records of compliance activities and reports compliance activities to the Compliance Office.

 

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification.  They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.

PHYSICAL DEMANDS*

Ability to lift up to 15 lbs independently not to exceed 50 lbs without assistance
Bending/Stooping - Occasionally (activity or condition exists up to 1/3 of time)
Climbing - Not Present
Hearing/Speaking - Effective communication with employees, supervisors/managers and staff. Effective communications with patients and visitors, as required.
Lifting - Occasionally (activity or condition exists up to 1/3 of time)
Pushing/Pulling - Occasionally (activity or condition exists up to 1/3 of time)
Sitting - Frequently (activity or condition exists from 1/3 to 2/3 of time)
Standing - Occasionally (activity or condition exists up to 1/3 of time)
Walking - Occasionally (activity or condition exists up to 1/3 of time)

WORKING CONDITIONS*

No potential for exposure to blood and body fluids

 

Address:  1575 Northeast Expressway, Bldg 1, Atlanta, GA  30329 
Function:  Revenue Cycle - Patient Financial Services


Nearest Major Market: Atlanta

Job Segment: Information Systems, EMR, Manager, Patient Care, SQL, Technology, Healthcare, Management