Clinical Revenue Integrity Manager - Clinical Rev Integrity - Full Time 8 Hour Days Exempt Non-Union
Clinical Revenue Integrity Manager - Clinical Rev Integrity - Full Time 8 Hour Days Exempt Non-Union
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$ 95680 - 158230
1 Vacancy
Job Description
Manages the administrative functions and provides operations support to the Department. Responsibilities include developing monitoring and providing operational support. Develops implements monitors and evaluates administrative procedures personnel administration payroll and budget development.
The Manager position will be primary responsible for overall revenue integrity via the management of the charge master dictionaries contract management EHR management terms and conditions and access that foundationally support all departments and vendors in relation to charging mechanisms and triggers ensuring clean handoffs between clinical departments and revenue cycle strategic pricing denials management. The position must continually keep abreast of regulation changes from all government and other payer updates. Further the position must lead all respective areas in charge capture and improvements for ensuring the highest level of efficiency integrity and compliance within our revenue cycle operations. Superior analytical knowledge is a must.
Essential Duties:
- Manage CDMs; Pricing and Fee Schedule; ensure hospital and clinic revenue integrity through charge creation deletion/changes and continually review for accuracy and compliance.
- Actively manage maintain and communicate to appropriate collaborators on charge capture rejection/suspended denial and improvement activities trends and recommended corrective action plans.
- Manage contract management load audit and maintenance hospital Health Record system charging related updates modifications.
- Manage all systems to improve overall change and account net down while working to identify areas for improvement and eliminate rework.
- Manage all systems access vendors access and payer sites for efficient and effort work efforts.
- Communicate to team collaborators stay informed of payer and/or regulatory updates create action plans to accommodate changes as needed.
- Monitors and manages charging workflows and reports in coordination with Revenue Cycle and Clinical departments to mitigate revenue leakages and optimize efficiencies.
- Prepares and delivers departmental summaries that pinpoint root causes of charge/billing errors and conceptualize process changes for Revenue Cycle and service line leaders.
- Engage collaborators to facilitate educational and workflow/process opportunities identified by team to improve documentation charging and clinical operations.
- Continually develop processes policy procedures and controls to drive revenue integrity.
- Supervises staff assigns work and counsels/disciplines if necessary.
- Performs other duties as assigned.
Required Qualifications:
- Req High school or equivalent
- Req Bachelors degree in business health administration or management.
- Req 57 years Charge master clinical coding and compliance knowledge and experience
- Req 2 years Prior supervisory/management experience.
- Req Strong orientation to detail and deadlines.
- Req Clear concise and persuasive writing and presentation skills
- Req Knowledge of hospital accounting procedures managed care revenue cycle case management and utilization patient financial services and reimbursement
- Req Strong skills in mainframe hospital accounting systems; personal computers; and spreadsheets
Preferred Qualifications:
- Pref Specialized/technical training Training Courses in CDM Strategic Pricing Billing and Regulatory Compliance Revenue Cycle preferred
- Pref Cerner Revenue Cycle Experience preferred
Required Licenses/Certifications:
- Req Fire Life Safety Training (LA City) If no card upon hire one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)
- Req Certified Coding Specialist CCS (AHIMA) Active certification as Certified Coding Specialist (CCS) Certified Coding SpecialistPhysician Based (CCSP) (AAPC/AHIMA) or equivalent. If no certification upon hire one must obtained within 2 years of hire and maintained by renewal before expiration date.
USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin protected veteran status disability or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance and with due consideration for patient and student safety. Please refer to theBackground Screening Policy Appendix Dfor specific employment screen implications for the position for which you are applying.
We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone ator by email at. Inquiries will be treated as confidential to the extent permitted by law.
- Notice of Nondiscrimination
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- Read USCs Clery Act Annual Security Report
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If you are a current USC employee please apply to thisUSC job posting in Workday by copying and pasting this link into your browser:
Experience:Manager
Employment Type
Full-Time
Key Skills
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