Systems Manager of Revenue Integrity Full Time-Onsite

Bristol Hospital Group; Bristol (CT); On-site; USD 75,000 - 120,000; Full time

Job summary

Bristol Health is seeking a Systems Revenue Integrity Manager to define and execute strategy for maximizing revenue capture across the Bristol Health enterprise, reporting to the Systems Revenue Cycle Director in Bristol, CT. This role liaises between revenue cycle and clinical departments to drive financial improvement through analytics and reporting.

Responsibilities include leading the Revenue Integrity Department, monitoring charge capture, reconciliation, CDM management, pricing strategy,

Qualifications

• Master’s degree in Health Care Administration, Business Administration or equivalent preferred.
• Eight years hospital revenue cycle or reimbursement experience, including seven (7) years Management experience, with emphasis on project management.

Responsibilities

• Lead the Revenue Integrity Department in the efficient and compliant manner of the Revenue Cycle.
• Oversee monitoring and improvement efforts within Revenue Integrity: Charge Capture, Revenue Reconciliation, CDM Management, Strategic Pricing, Payment Validation, Denial Prevention, and Reporting/Analytics.
• Oversee all functions performed by the Revenue Integrity team, including analytics, communication with departments and external stakeholders, and ongoing strategy of the program.
• Develop meaningful metrics and KPIs with teams to drive analysis and decision-making.
• Lead revenue improvement opportunities and analyze financial impact for professional and hospital departments.
• Collaborate with Revenue Cycle and Finance leadership to prioritize focus areas and ensure ongoing performance.
• Assist in developing and maintaining controls and security of processes for accurate operations.

Education

Master’s degree in Health Care Administration, Business Administration or equivalent preferred

Job description

Job Details

Job Location: BHI Valley St - Bristol, CT, Position Type: Full Time, Education Level: Graduate Degree, Salary Range: $75000.00 - $120000.00, Job Shift: 1st Shift (Days), Job Category: Finance.

Under the direction of the Systems Revenue Cycle Director, the Systems Revenue Integrity Manager defines and carries out the strategy for maximizing gross and net revenue capture across the Bristol Health enterprise. The Manager serves as the chief liaison between revenue cycle and clinical departments. The Manager also ensures the availability and interpretation of reporting and analytics necessary for the clinical and revenue cycle departments to drive financial improvement.

Benefits

We offer a comprehensive benefits package designed to support the health, financial well-being, and work-life balance of our employees and their families. Eligible team members have access to medical, dental, and vision insurance, paid time off (PTO) and paid leave, a 403(b) retirement savings plan with company matching, company-paid life insurance, and an array of additional perks including employee assistance and wellness programs. (Exact eligibility and coverage details vary by role and employment status.)

Essential Job Functions and Responsibilities

• Lead the Revenue Integrity Department in the efficient and compliant manner of the Revenue Cycle.
• Oversee monitoring and improvement efforts within the functional areas of Revenue Integrity, including:
  • Charge Capture – Ensure appropriate audit activities take place prior to and after billing to ensure accurate and optimal revenue capture and seek to continually improve charging processes within departments.
  • Revenue Reconciliation – Provide oversight of Revenue Reconciliation completed by operational and clinical leads across Bristol, including the use of appropriate tools to support revenue and charging reconciliation.
  • CDM Management – Ensure the Charge Description Master is maintained, new codes are entered timely, and any pre-bill edits are worked timely.
  • Strategic Pricing – Provide oversight for annual price increases across the organization. Understand pricing goals and net impact of associated price increases.
  • Payment Validation – Ensure accurate reimbursement by payors through internal processes and tertiary processes.
  • Denial Management & Avoidable Write-Off Prevention – Utilize data analytics to identify trends and work with functional areas for future prevention.
  • Reporting & Analytics – Provide objective analysis through advanced reporting and interpretation of findings to support Revenue Integrity processes.
• Oversee all functions performed by the Revenue Integrity team, including analytics and reporting, communication with departments and external stakeholders, and ongoing strategy and development of the program.
• Work with team to develop meaningful metrics and key performance indicators departments to drive strategic analysis and decision-making.
• Lead targeted revenue improvement opportunities and assist with analyzing the financial impact as related to professional and hospital clinical departments.
• Work proactively with leadership within Revenue Cycle and Finance to prioritize areas of focus and ensure appropriate ongoing performance.
• Assist in the development and maintenance of appropriate controls and security of processes that lead to accurate clinical, operational, and financial operations.

Qualifications

Educational / Minimum Requirements

• Master’s degree in Health Care Administration, Business Administration or equivalent preferred
• Eight years hospital revenue cycle or reimbursement experience, including seven (7) years Management experience, with emphasis on project management.

State/Federal Mandated Licensure or Certification Requirements

None

Bristol Hospital Mandated Educational Requirements

General orientation at time of hire. Fire/Safety/Infection Control annually.

Special Requirements

• Ability to effectively manage multiple tasks and projects.
• Strong computer analytical skills with an aptitude for learning new software programs and the ability to assimilate changes.
• Outstanding supervisory and interpersonal skills.

Physical Requirements

Prolonged sitting at a desk and/or computer terminal. Significant paperwork requiring extensive eye usage. Physically able to handle paperwork and patient filing. Vision and hearing corrected to normal.

Work Environment

Normal office conditions.

Cognitive Requirements

Strong interpersonal skills; ability to deal effectively with physicians, clients, and other related professional personnel. Excellent mathematical and analytical skills; must be able to reconcile patient accounts and spreadsheets expediently. Detail oriented personality. Excellent written and oral communication skills. Ability to work independently with minimal direct supervision.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.