Manager, Revenue Integrity

Ensemble RCM LLC; South Carolina; Hybrid; USD 84,000 - 110,000; Full time

Job summary

Ensemble Health Partners seeks a Manager of Revenue Integrity to oversee revenue integrity and charge capture across client hospitals and affiliated groups. The role ensures compliant charging, timely filing, and denial reduction while driving performance improvements in Epic and across the Revenue Cycle.

The position requires leadership in Revenue Cycle operations, strong analytics, and the ability to develop staff and training programs to meet financial goals and deliver high-quality client

Qualifications

• Legally Required License / Certification (Ex: MD, RN, LPN, etc.) ONE CERTIFICATION PER FIELD Ensemble Required License / Certification (Ex: CRCR) ONE CERTIFICATION PER FIELD - CRCR through HFMA, Coding certification or equivalent Or other approved job relevant certification.
• 5 to 7 Years - Overall work experience
• 3 to 5 Years - People leadership experience
• Experience in Healthcare operations, Revenue Cycle Operations, Charge Capture, Billing

Responsibilities

• Resolve revenue integrity edits to send claims to insurance companies for timely payment.
• Identify trends and issues related to charge capture practices.
• Educate clinical staff on appropriate charge capture and revenue reconciliation processes.
• Attend and coordinate department weekly & monthly meetings.
• Interviewing, hiring, staffing, and performance management of staff.
• Develops and maintains training and education program for new hires and existing staff.
• Develops, updates and implements job standards, duties, departmental policies and performance appraisals.
• Prepares monthly analytics reports and communicates performance data.

Skills

People leadership

Revenue cycle operations

Charge capture

Healthcare operations

Staff training

Education

High School Diploma, GED, or Equivalent

4 year/ Bachelors Degree

Job description

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!

O.N.E Purpose:

Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.

Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference principles and consistently delivering outstanding results.

Job Summary

The Manager of Revenue Integrity manages all Revenue integrity & charge capture activities, and is responsible for performance and effectiveness of the department. The Manager will be responsible for implementing short and long-term plans and objectives to ensure resolution of revenue integrity edits in Epic within set deadlines, ensure compliant charge capture practices, ensure claims timely filing, & reduce denials. Additionally, they will work with all departments within the Revenue Cycle to manage DNFB, coordinate efforts and ensure timely payments by insurance companies. They will empower staff to develop methods of process improvement, including planning, setting priorities, conducting systematic performance assessments, implementing improvements based on those assessments and maintaining achieved improvements. Set standards of behaviors and performance for the department based on the Ensemble Difference principles.

Job Functions

Manages all revenue integrity activities performed by staff across all Ensemble clients. Staff responsibilities include resolving revenue integrity edits to send claims to insurance companies for timely payment, identify trends and issues related to charge capture practices, educate clinical staff on appropriate charge capture and revenue reconciliation processes. Working with other departments within the Revenue Cycle to ensure compliant charging and billing practices, identify trends in charge capture errors, and provide necessary education to facilitate accurate charging and billing. Attend and coordinate department weekly & monthly meetings. Responsible for interviewing, hiring, staffing, performance management and development of staff. Counsels and disciplines employees when necessary in accordance with department and/or organizational policies. Develops and maintains the training and education program for new hire and for existing staff. Develops, updates and implements job standards, job duties, departmental policies and performance appraisals for all areas of responsibility. Prepares monthly analytics reports as requested by management. Establishes departmental goals with the staff to optimize performance and meet budgetary goals while improving operations to increase customer satisfaction and meet financial goals of the organization. Collects, interprets and communicates performance data using various tools and systems, while also using this data to make decisions on how to achieve performance goals. Works with internal and external customers to make key decisions, impacting either the organization or an individual patient. Works closely with ancillary departments to establish and maintain positive relations to ensure revenue cycle goals are achieved. Assists in strategic planning and performs ongoing process improvement evaluation. Reviews, updates and implements policies and procedures to support the vision and goals.

Employment Qualifications

Legally Required License / Certification (Ex: MD, RN, LPN, etc.) ONE CERTIFICATION PER FIELD Ensemble Required License / Certification (Ex: CRCR) ONE CERTIFICATION PER FIELD - CRCR through HFMA, Coding certification or equivalent Or other approved job relevant certification.

5 to 7 Years - Overall work experience 3 to 5 Years - People leadership experience Education Level - High School Diploma, GED, or Equivalent Experience General Office Environment or Work From Home - No

Other Preferred Knowledge, Skills and Abilities

• Required Minimum Education - Specialty/Major: Business or Health care field
• Preferred Minimum Education: 4 year/ Bachelors Degree
• Preferred Minimum Education - Specialty/Major: Business or Healthcare field
• Minimum Years and Type of Experience: 5 or more years of experience in Revenue Integrity or Revenue Cycle Operations
• Other Knowledge, Skills and Abilities Required:
• Experience in Healthcare operations, Revenue Cycle Operations, Charge Capture, Billing

Salary: $84K to $110K depends on experience, skills, education, interview and other qualifications

Join an award-winning company

Five-time winner of “Best in KLAS” 2020-2022, 2024-2025 Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024 Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024 Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023 Energage Top Workplaces USA 2022-2024 Fortune Media Best Workplaces in Healthcare 2024 Monster Top Workplace for Remote Work 2024 Great Place to Work certified 2023-2024 Innovation Work-Life Flexibility Leadership Purpose + Values Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive.

A few of those include: Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs. Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation. Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement. Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.

Due to business, operational, payroll, and regulatory requirements, this position is limited to individuals who reside and are authorized to work within the United States. Applications generated from outside the United States will not be considered. Individuals may reapply when located within the United States.

Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact [e-mail].

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.