Manager Revenue Integrity - Revenue Integrity & CDM

Location: MetroHealth Old Brooklyn Campus

Biweekly Hours: 80.00

Shift: Days

The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it. Founded in 1837, Cuyahoga County's safety-net health system operates four hospitals, four emergency departments and more than 20 health centers.

Summary:


Responsible for maintaining the integrity of the revenue capture system across the Health System. Focuses on the maximization of collections through the accurate and complete capture of all charges as well as the implementation and maintenance of charge capture processes. Works closely with clinical departments to align processes with government, payer, and internal charge capture policies; provides education to the clinical departments. Responsible for the planning and implementation of Revenue Integrity and charge capture projects including developing work teams, delegating tasks, workflow and training and development of staff. Analyzes and generates reports to monitor activity and recommend opportunities to increase revenue and reimbursement for the Patient Care Units (PCU's). Knowledgeable of governmental and third party payer regulations and comprehensive knowledge of billing and reimbursement processes. Provides regular updates of the PCU area performance, which may include training and educational opportunities. Upholds the standards of the system-wide customer service program.

Qualifications:

Required:

  • Bachelor's Degree in Business Administration, Healthcare, Finance or other applicable field
  • In lieu of degree, will accept a minimum of five years experience in billing and coding
  • 5-7 years of healthcare related experience 2 years of direct management experience
  • Working knowledge of financial statements and ability to analyze financial information and determine financial impact of possible changes
  • Revenue cycle experience in a major academic health care organization.
  • Demonstrated strong verbal and written communication skills, strong interpersonal skills, and listening skills.
  • Excellent presentation skills and facilitation skills. Strong knowledge of medical coding (must include both ICD-9 and CPT-4 coding)


Preferred:

  • Master's Degree in a business related field.
  • Certification in billing and coding represented by any of the following: RHIA, RHIT, RN, CPC, COC, CCS, or CCS-P