Premier Health System Support

110 N. Main St. Dayton, OH 45202

Department: Finance

Full Time/ 8am-5pm (Monday through Friday)

We are seeking a skilled Revenue Manager to oversee our company's revenue management strategies and maximize profitability. The ideal candidate will be responsible for analyzing revenue data, developing pricing strategies, and implementing revenue optimization techniques to drive business growth.

Under the general direction and guidance of the Director of Reimbursement, the Manager of Revenue Integrity is responsible for the daily operations of the Charge Master staff. The Manager is responsible for developing standards and ensuring the integrity of the Premier Health Hospitals revenue. This includes the following critical components: managing all aspects of the Charge Description Master and fee schedule formulation(s), review and maintenance of charging practices to optimize revenue generation, building and monitoring compliance with third party payer requirements; manage the charge entry and reconciliation process, collaborate with all service lines across the system; policies and procedures development, and modification and maintenance of the hospital CDM. The Manager of Revenue Integrity also is responsible for developing a charge audit/capture/reconciliation process and ensuring charges are maximized for reimbursement. The Manager must have a strong understanding of Medicare & Medicaid regulations as well as understanding implications of CDM changes to Managed Care contracts.

The Manager of Revenue Integrity is responsible for the pricing of all charges associated with charge master and charge build. This includes maintain the fee schedules which drive hospital pricing onto claims. The Manager is responsible for the annual rate increase across all Premier Health hospital departments and the annual code changes published by both the American Medical Association (AMA) and Medicare (CMS). The Manager participates in compliance and billing related activities and denials root cause and process improvement, as appropriate.

Qualifications

Education

Minimum Level of Education Required: Bachelor's degree

Type of degree: Finance or Related field

Preferred educational qualifications: Graduate Degree

Licensure/Certification/Registration

Epic Hospital Billing or Epic Charge Master is preferred. Coding certification in at least one of the following is also preferred: CPC, CPC-P, RHIA, RHIT, and/or certification in auditing and/or Healthcare compliance. Designation of proficiency in Hospital Billing and Charge Master is required.

Experience

Minimum Level of Experience Required: 5 - 7 years of job related experience

Prior job title or occupational experience: Minimum of five to seven years in hospital finance and or healthcare reimbursement. 3 to 5 years of prior management experience required.

Other experience requirements:

• A strong understanding of healthcare reimbursement required
• Knowledge of CPTs, APCs, DRGs, and HCPCS code is required
• Current knowledge hospital billing practices is required.
• Current knowledge of Medicare and Medicaid regulations is required.
• Two years of project management experience
• Experience in working with upper management, physicians, and information systems is required
• File maintenance experience required
• Report writing experience required
• Understanding of Managed Care contracts and language

Knowledge/Skills/Abilities

• Lead projects and work with external consultants when necessary
• Adept analytical skills and a proven strong attention to details
• Develop effective solutions for complex business challenges
• Ability to research and evaluate information
• Strong interpersonal skills necessary to interact with all departments
• Strong written and communication skills
• Able to prioritize and coordinate multiple projects simultaneously
• Strong leadership skills

Duties
- Analyze revenue data and market trends to identify opportunities for revenue growth
- Develop and implement pricing strategies to optimize revenue streams
- Monitor and evaluate the effectiveness of revenue management strategies
- Collaborate with cross-functional teams to align revenue goals with overall business objectives
- Utilize revenue management software to track performance metrics and generate reports
- Stay updated on industry best practices and trends in revenue management

Requirements
- Bachelor's degree in Business Administration, Finance, or related field
- Proven experience in revenue management or a similar role
- Strong analytical skills with the ability to interpret complex data sets
- Excellent communication and interpersonal abilities
- Proficiency in revenue management software and Microsoft Excel
- Knowledge of industry-specific regulations and compliance standards

Job Type: Full-time

Pay: $81,335.00 - $104,642.00 per year

Experience:

• Medicare: 1 year (Required)
• Project management: 1 year (Required)
• Management: 1 year (Required)

Ability to Commute:

• Dayton, OH 45402 (Required)

Work Location: In person