Revenue Integrity Manager

ECU Health; Greenville (NC); Remote; USD 85,000 - 115,000; Full time

Job summary

ECU Health is seeking a mid-senior level Revenue Integrity Manager. This role focuses on maximizing net revenue through efficient revenue cycle management, compliance with payer regulations, and leadership training. Candidates should possess a Bachelor's degree in the relevant field along with substantial experience in revenue integrity.

Benefits

Great Benefits

Flexible working hours

Qualifications

• 5+ years of experience in Revenue Integrity or hospital revenue cycle operations.
• 3+ years of leadership experience in revenue integrity or charge capture.

Responsibilities

• Evaluate revenue cycle functions to maximize net revenue.
• Research and analyze data to resolve issues related to billing.
• Ensure compliance with third-party regulations and timely resolution of billing edits.

Skills

Leadership

Analytical Skills

Data Analysis

Healthcare Knowledge

Revenue Cycle Management

Education

Bachelor's degree in Healthcare Administration or related field

Job description

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About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

ECU Health

About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Childrens Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.

Position Summary

The Revenue Integrity Manager (CDM) evaluates revenue cycle functions across ECU Health with the goal of maximizing net revenue for the system. Accomplish established goals through direct management in areas of responsibility and provide mentoring and training to supervisors with a focus on quality improvement and leadership. Continuously research, monitor, and implement payer regulations and guidelines related to revenue management activities. Ensure Charge Description Master is in compliance with Third Party Regulations and Requirements. Ensure timely resolution of billing edits and denials to contribute to goals for days in Accounts Receivable and cash collections.

Responsibilities

• Evaluate revenue cycle functions across UHS with the goal of maximizing net revenue for the system.
• The revenue cycle manager reviews processes across UHS that are dedicated to the capture and management of revenue.
• Provides leadership to key revenue cycle functions to drive needed process changes and adherence.
• Researches and analyzes data to resolve issues. Works with the impacted areas to develop and implement solutions.
• Develops and utilize reports to track financial and operational performance across the entire spectrum of the revenue cycle.
• Ensure Charge Description Master is in compliance with Third Party Regulations and Requirements
• Evaluate latest technology available for Charge Master Maintenance.
• Continually evaluate processes to be in line with industry best practices
• Manage Annual Rate Increase by working with Cost Management and Financial Services Administration.
• Ensure timely resolution of billing edits and denials to contribute to goals for days in Accounts Receivable and cash collections.
• Ensure reporting and communication of denials /billing edits is completed in a timely manner.
• Work with Central Billing office to streamline processes between departments.
• Serve as resource for the Central Billing office on regulatory and compliance issues.
• Accomplish established goals through direct management in areas of responsibility. Provide mentoring and training to supervisors with a focus on quality improvement and leadership.
• Develop and utilize management models to monitor productivity and quality of staff performance.
• Develop goals for Departmental Supervisors that support Revenue Cycle improvement as well as maintain/improve existing functions.
• Continually assess departmental structure to ensure cost savings and net revenue opportunities.
• Incorporate ECU Health standards, including the principles of the Journey to Excellence in all aspects of management.
• Continuously research, monitor, and implement payer regulations and guidelines related to revenue management activities.
• Leverage clinical and coding staff within finance to bridge the gap between clinical and financial services and improve communication.
• Develop educational materials/programs for departments with an impact on the revenue cycle at ECU Health.
• Utilize knowledge of reimbursement and billing to assist in special projects. Provide information on reimbursement streams for new ventures or changes in business practices at ECU Health.
  
  

Minimum Requirements

• Bachelor's degree in Healthcare Administration, Business, Finance, Health Information Management (HIM), or a related field required.
• 5+ years of experience in Revenue Integrity, Charge Description Master management, or hospital revenue cycle operations.
• 3+ years of leadership experience in revenue integrity, CDM, or charge capture.
  
  

Other Information

• 40 hours a week
• Remote ()
• Monday - Friday (8 am - 5 pm); flexible working hours
• Great Benefits
  
  

General Statement

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicants qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Accounting/Auditing and Finance

• Industries

  Hospitals and Health Care

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