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Revenue Integrity Manager
Tift Regional Health System
Location: Tifton, Georgia
Work Setting: Hospital
Job Function: Other
Job Type: Full-Time
The Revenue Integrity Manager is responsible for organizing and managing the daily operations of the Revenue Integrity department. The manager will oversee quality control audits to ensure documentation integrity, communication of audit findings and recommendations and provide education related to regulatory requirements for billing to auditing, clinical providers, coding and billing staff.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Provides leadership guidance to the Chargemaster Analyst, Revenue Integrity audit, charge abstraction and release of information teams by coordinating and monitoring workflows and daily tasks.
- Manages the government and commercial payer audit and recovery programs
- Proactively identifies potential adverse audit outcomes, revenue leakage and works with director on developing plans to address opportunities
- Maintains knowledge of government and payer audits practices, trends and compliance related topics
- Partners with clinical areas and revenue cycle areas to ensure compliance with government and payer practices
- Provides ongoing education and training on best practices based on audit findings and payer guidelines
- Manages the workflows and practices for department
- Works with director to develop and maintain policies, procedures and guidelines for department
- Must interact with all other hospital personnel, patients, visitors, family members, and contract personnel.
- Practice standard precautions for Infection Control; adhere to safety policies and procedures; attend mandatory in-services; maintain helpful, caring attitude.
- Adheres to TRMC Compliance Program, Code of Conduct and TRMC policies and procedures including HIPAA.
CORPORATE COMPLIANCE RESPONSIBILITIES
- Keeps abreast of all pertinent federal, state and TRHS’ regulations, laws and policies as they presently exist and as they change or are modified.
- Ensures that the staff are trained and evaluated on their knowledge of and adherence to compliance policies and procedures specific to their jobs by team rounding, huddles and staff meetings.
Must have knowledge of Revenue Integrity, Chargemaster, denials/appeals and charge audit practices. Must be knowledgeable about reimbursement systems and legal issues affecting medical records. Must have basic knowledge of medical terminology and anatomy. Must have excellent communication and teaching skills. Must have above average computer skills including operation of a P.C. with word processing. Must be dependable; exhibit professionalism; have integrity; be able to communicate effectively both verbally and in writing; possess problem solving skills; possess organizational skills; be in good general health; complete pre-employment and annual physical requirements (including alcohol and drug screens)
5-10 years of experience in Revenue Cycle leadership preferred.
Bachelor’s degree in business administration, healthcare administration or other related degree required.
Instructions for Resume Submission
Apply online at https://www.tiftregional.com/careers
Apply Online: https://www.tiftregional.com/careers
Posted: May 13, 2020 at 9:02 AM
Post ID: 50683