Revenue Integrity Manager

Role Overview

• Plans, organizes, develops and implements revenue cycle operations to meet UT Le Bonheur Pediatric Specialists and departmental goals and objectives
• Maintains appropriate internal controls over front end billing functions, patient registration, pre-certification, procedure authorizations, insurance verification, charge entry and coding
• Keeps abreast of all reimbursement billing procedures of third party and private insurance payers
• Manages patient registration, pre-certification, procedure authorization, coding, and charge posting, advising supervisors on day-to-day implementation and interpretation to ensure compliance with all policies and procedures
• Provides analysis with regard to financial impact of new MH ULPS business opportunities and decisions
• Manages, and controls development and implementation of product and procedure pricing for ULPS
• Manages along with the CBO, the re-certification/clinical denials management process including the clinical appeal, rebilling, and verification process
• Promotes the flow of information by establishing, utilizing, and maintaining effective communication systems within and outside the department
• Develops, analyzes, and reviews special projects as necessary
• Manages the process of internal and external charge/chart audit
• Designs and implements training programs to ensure that all areas are adequately trained on charge capture and reconciliation policies and procedures
• Designs process to capture lost charges missed by ULPS billing areas to ensure maximum legitimate reimbursement for the services provided
• Maintains and develops a competent, productive, and quality conscious workforce by hiring, evaluating performance, counseling, training, issuing corrective action, and recommending promotion or discharge of department personnel according to the MH value

Requirements

• Bachelor's Degree in Business Administration/Management
• In lieu of Bachelor's degree, must have a High School diploma with four (4) years equivalent experience in business practices, accounting and finance
• Ability to understand and prepare written materials, such as management reports and memos
• Ability to communicate verbally with all levels of Associates, senior management officials, and other outside professionals
• Ability to lead and motivate individuals and groups of people toward the accomplishment of work and organizational goals
• Ability to organize multiple tasks and projects and maintain control of workflow
• Ability to work without close supervision or guidance and exercise independent judgment
• Ability to facilitate education/training sessions at all levels of the organization

Benefits

• Health insurance
• Retirement plans
• Paid time off
• Flexible work arrangements
• Professional development