Supervisor Revenue Integrity - HIM Revenue Integrity

UNC Health; North Carolina; Remote; USD 40,000 - 57,000; Full time

Job summary

UNC Health in Chapel Hill, NC seeks a Supervisor of Revenue Integrity to lead the daily operations of the Revenue Integrity Program across the health system. You will supervise staff and processes to ensure accurate charge capture and compliance.

The role involves collaboration with Compliance, Internal Audit, and legal to address billing and coding issues while meeting SLA and regulatory standards.

Qualifications

• Bachelor's degree required; or equivalent combination of education, training and experience.
• Two (2) years of relevant experience and one (1) year of supervisory or team lead experience with Bachelor’s degree.
• Six (6) years of relevant experience and one (1) year of supervisory or team lead experience with Associate’s degree.
• Ten (10) years of relevant experience and one (1) year of supervisory or team lead experience with High School diploma or GED.

Responsibilities

• Oversee daily revenue integrity processes including charge capture/review, DNB edits, CCI/OCE, and other pre/post bill edit activities; manage staffing and drive quality and productivity to meet SLA goals.
• Collaborate with Compliance Office, Internal Audit, legal counsel and outside consultants to review and resolve identified billing, coding, charging, and compliance issues.
• Engage Revenue Cycle leaders and other teams to identify missed charges and educate on changes in charge practices and medical necessity per guidelines.

Skills

CCI edits

Billing compliance

Analytical skills

Regulatory knowledge

Education

Bachelor's degree in a related field

Associate's degree

High school diploma or GED

Job description

Description

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.

Summary

The Supervisor of Revenue Integrity will be responsible for staff oversight and the daily operational processes of the UNC Health Care System Revenue Integrity Program. Additionally, the Supervisor is responsible for ensuring processes are conducted efficiently and in a high quality manner to meet service level agreement (SLA) expectations and regulatory standards for Revenue Integrity.

Responsibilities

• Operational supervision and responsibility of the daily processes that cover charge capture/review, DNB edits, CCI/OCE and other pre/post bill edit processing, OBSV review/carve‑outs, Infusion & Injection, and ED Charge Review through effective staffing plans and work assignments. Drives operational workflow with accountability for meeting established quality and productivity goals while seeking ways to improve the efficiency and accuracy of associated work functions (both direct and indirect) across the health care system. Responsible for providing team members with the tools and training needed to effectively meet these goals.
• Advises and collaborates with the Compliance Office, Internal Audit, legal counsel and outside consultants to analyze, review and assess identified billing, coding, charging, and compliance issues.
• Actively engage Revenue Cycle leaders, Clinical Liaisons, and other team members to proactively identify opportunities to avoid missed charges and/or incorrectly charged services and to provide education as it pertains to changes in charge practices and medical necessity, in accordance with local/national guidelines.

Education Requirements

• Bachelor's degree in a related field (or equivalent combination of education, training and experience).

Licensure/Certification Requirements

• No licensure or certification required.

Professional Experience Requirements

• If a Bachelor's Degree: Two (2) years of relevant experience and one (1) year of supervisory or team lead experience.
• If an Associate's Degree: Six (6) years of relevant experience and one (1) year of supervisory or team lead experience.
• If a High School Diploma or GED: Ten (10) years of relevant experience and one (1) year of supervisory or team lead experience.

Knowledge/Skills/and Abilities Requirements

• Ability to research complex coding and regulatory requirements in order to understand and analyze payer regulations as well as coding guidelines. Extensive knowledge of Correct Coding Initiative (CCI) edits, CPT, HCPCS, ICD, Revenue Codes, modifiers, billing, regulations and guidelines (Medicare, Medicaid, third-party billing rules, coverage, payment, and compliance).Results oriented with the ability to meet deadlines in a fast‑paced, dynamic, project‑oriented environment; Proficient in time management with superior prioritization skills. Must be self‑motivated and detail‑oriented with strong analytical and critical‑thinking skills Effective verbal and written communication skills with the ability to professional present information to all levels of management. Understanding of overall hospital revenue cycle functions.

Job Details

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: HIM Revenue Integrity

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: $28.87 - $41.50 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Remote

Work Schedule: Day Job

Location of Job: US:NC:Chapel Hill

Exempt From Overtime: Exempt: Yes

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [e-mail] if you need a reasonable accommodation to search and/or to apply for a career opportunity.