What are the responsibilities and job description for the REVENUE INTEGRITY MANAGER, REVENUE INTEGRITY position at SGMC Health?
Description
Location: SGMC Patient Financial Services
Department: REVENUE INTEGRITY
Schedule: Full Time, 8 HR Day Shift, 8:00am - 5:00pm
Position Summary
In collaboration with the Revenue Integrity Director, the Revenue Integrity Manager oversees and optimizes revenue cycle processes within our healthcare organization to ensure accurate billing, coding, and compliance with regulations, maximizing revenue and minimizing financial losses.
EDUCATION
Modern, well-lighted, air-conditioned, general office area and clinical areas with revenue generating departments. Moderate/high stress level. Ability to sit, stand, or walk for moderate periods. Moderate heavy lifting (0-25 pounds), reaching, stooping, pushing, pulling, bending, and twisting.
Location: SGMC Patient Financial Services
Department: REVENUE INTEGRITY
Schedule: Full Time, 8 HR Day Shift, 8:00am - 5:00pm
Position Summary
In collaboration with the Revenue Integrity Director, the Revenue Integrity Manager oversees and optimizes revenue cycle processes within our healthcare organization to ensure accurate billing, coding, and compliance with regulations, maximizing revenue and minimizing financial losses.
EDUCATION
- Bachelor’s degree from an accredited college in a healthcare discipline or five (5) years experience in a related field
- CPC, CCS, COC, RHIT or other coding certification preferred
- Minimum three (3) years of CDM experience
- Strong coding background/knowledge required.
- EPIC experience required.
- Knowledge of facility charge master principles and the relationship to coding, billing, reimbursement and compliance in a hospital or health system setting.
- Working knowledge of CPT/HCPCS coding, CMS regulations, and UB Revenue Codes required.
- Strong communication, interpersonal, and rapport-building skills.
- Strong analytical skills and problem-solving skills.
- Analyze data, identify trends, and develop solutions to improve revenue integrity.
- Knowledge of healthcare regulations and compliance, including current billing, coding, and compliance regulations.
- Familiarity with billing, coding, claims submission, and other revenue cycle functions.
- Effectively supervise and mentor staff, manage projects, and drive improvement initiatives.
- Effectively communicate with stakeholders, including clinicians, billing staff, and leadership.
- Excellent oral and written communication skills including the ability to teach complex technical / analytical concepts to SGMC Health leaders and team members.
- Ability to manage large, complex, simultaneous assignments with potentially conflicting priorities and deadlines.
- Proficient in relevant software and systems used for revenue cycle management. This may include Microsoft Office applications (Excel, Word, PowerPoint), EPIC, Craneware, and third-party clinical interface applications.
Modern, well-lighted, air-conditioned, general office area and clinical areas with revenue generating departments. Moderate/high stress level. Ability to sit, stand, or walk for moderate periods. Moderate heavy lifting (0-25 pounds), reaching, stooping, pushing, pulling, bending, and twisting.
