Manager of Revenue Integrity (REMOTE)
Location: Austin, Texas US
Job Number: 1127
Position Title: Manager of Supplemental Revenue Cycle Operations
The Manager of Revenue Integrity is responsible for leading and managing a team dedicated to optimizing practice revenue and improving operational proficiency through strategic claims management for client practices. This position requires a thorough understanding of the medical revenue cycle, medical coding and billing processes. The Manager is responsible for providing full-scale revenue cycle services to our practices under a contractual arrangement, which may include medical coding, charge entry, denial resolution, overall accounts receivable management, general customer service, training, reporting, analysis, and P&L management. The successful applicant will have demonstrated experience in driving continuous performance improvements through data analysis, system optimization, other automation techniques (e.g. RPA), provider education and/or RCM process changes.
Essential Job Functions:
- P&L owner for the enhanced operations service model; responsible for delivering high quality services to practice clients while ensuring high staff productivity, effective cost control, and positive contributions to the company’s margins
- Responsible for on-going denial trend research and analysis, including evaluation of payors’ clinical, coding and reimbursement policies spanning all markets, and translating that information into action plans that drive end-to-end performance improvement.
- Leverages functionality of revenue cycle management application to increase clean claim rate, reduce denial rates and increase cash collections, through implementation of claim rules and edits.
- Manages and supports the operations team by providing leadership, mentoring and strategic direction to drive change and optimization of practice revenue.
- Oversight of vendor performance and operations, through documentation of workflows to track and develop enhancements to processes.
- Informs the Sr. Manager and leadership of any identified or potential revenue cycle issues, team performance, and assists in the development of identified areas of RCM+ team growth.
- Prepares and presents practice financial performance data to practice and departmental leadership.
- Communicates with practices on education topics, such as workflow improvements, payor denial trends, documentation deficiencies, registration issues, etc.
- Assures claim coding is supported by documentation and identifies outliers based on clinical documentation, ensuring accuracy and proper reimbursement.
- Performs quality assessments on an on-going basis; oversees the capture and analysis of data regarding operational performance and quality control; ensures all coding is completed with regulatory compliance; develops and maintains productivity metrics.
- Additional tasks as assigned.
- Minimum of 5 years’ experience in healthcare medical coding or billing environment.
- College degree desired.
- Certified coder certification (CPC/CCS) preferred.
- Intermediate to advanced proficiency in Microsoft Excel and PowerPoint preferred.
- Strong presentation skills, with ability to effectively communicate to Executive and Physician leadership teams on KPIs and strategic priorities.
- Excellent relationship building skills and aptitude for working collaboratively with cross-functional groups.
- Knowledge of NCDs / LCDs and how to successfully navigate updates to decrease impact to claim processes.
- Strong working knowledge of payor denials and policies.
- Able to independently manage multiple tasks and deadlines, with minimal oversight.
- Able to clearly document processes and facilitate process to external users.
- Knowledge of Athena Collector desired.
- Demonstrated attention to detail required.
- Critical thinker with ability to problem solve, perform root-cause analysis and implement action plans.
- Strong knowledge of payor and clearinghouse claim edits and rules.
- Strong analytical skills are required.
- Ability to handle multiple projects concurrently.
- Excellent verbal and written communication skills.
Community / Marketing Title: Manager of Revenue Integrity (REMOTE)
Unified Women’s Healthcare is a company dedicated to caring for Ob-Gyn providers who care for others, be they physicians or their support staff. A team of like-minded professionals with significant business and healthcare experience, we operate with a singular mindset - great care needs great care. We take great pride in not just speaking about this, but executing on it.
As a company, our mission is to be an indispensable source of business knowledge, innovation and support to the practices in our network. We are advocates for our Ob-Gyn medical affiliates – enabling them to focus solely on the practice of medicine while we focus on the business of medicine.
We are action oriented. We strategize, implement and execute – on behalf of the practices we serve.
EEO Employer Verbiage:
We offer a competitive salary and an excellent benefit package that includes health/dental/life/STD/LTD/vision insurance, paid time off, and 401(k) plan. This company is a drug-free workplace and an Equal Employment Opportunity employer.