REVENUE INTEGRITY SUPERVISOR - REVENUE INTEGRITY

Status:  Full Time

Shift:     40 hours/week including rotating/on-call weekend shifts

Exempt: No 

Summary:

Provides supervision, leadership, workflow organization, and training for Revenue Integrity Specialist.Responsible for monitoring and maintaining charging process. All work must be completed timely and tactfully in a manner that is ethical and compliant and provides the basis for accurate bills.

Other information:

1.Previous Experience:
Required:2 years in revenue cycle in a healthcare organization.Strong communication skills.Strong analytical skills.Strong computer skills including Microsoft Word and Excel.
Preferred:Previous supervisory experience.Charge posting/auditing, HCPCS/CPT coding, billing charges, or clinical experience within health system.Proficiency in Epic.

2.Specialized or Technical Education:
Required:High school diploma with 3 years healthcare clinical knowledge/experience or high school diploma with completion of billing/coding program or Bachelor’s degree in Accounting, Finance, or related field.
Preferred:Working knowledge of coding or charging or billing guidelines in healthcare setting.

3.Manual or Physical Skill Required:
Proper vision, hearing, and body mechanics to operate computers, telephone, and other office equipment;to spend long hours sitting and working with computer;to occasionally walk between various departments;and to occasionally lift files or papers weighing up to 10 lbs.

Physical Effort Required/Physical Demands:
Strength:Sedentary
Push:Occasionally
Pull:Occasionally
Carry:Occasionally
Lift:Occasionally
Sit:Constantly
Stand:Occasionally
Walk:Occasionally

Responsibilities:

1.Supervise and manage the area of Revenue Integrity operations.

2.Monitor Revenue Integrity Specialists’ productivity and performance.Ensure that their duties are completed accurately and timely.

3.Responsible for Revenue Integrity Specialists’ evaluation, counseling, staff development, and training.

4.Understand Medicare, Medicaid, and other Payors regulations and guidelines as related to coverage of services.Provide guidelines for accurate charge information and sufficient documentation.

5.Understand the relationship between proper documentation and charges and be able to link the charges on the account/claim with the documentation in the medical record.Assist in efforts and ensure resolution when discrepancies or deficiencies are identified.

6.Implement and maintain audit process to identify charging risk areas.Compile information and/or prepare reports and analyses setting forth results of audits.

7.Review audit result performed by Revenue Integrity Specialists to ensure completeness and accuracy.

8.Review Revenue Integrity workflow, charge edits, and charge issues.Report trends, identify opportunities, make recommendations, and implement changes to improve documentation, charge accuracy, and productivity.

9.Understand and stay updated of chargemaster functionality.

10.Understand the full flow of revenue cycle and Revenue Integrity’s role in it.Implement changes in Revenue Integrity to expedite the completion of the revenue cycle.

11.Maintain relationship and communication with other departments as they relate to charge accuracy and process improvement. Collaborate with other departments to support revenue cycle.

12.Obtain and maintain up-to-date knowledge of HCPCS/CPT coding including revenue code, HCPCS/CPT code, modifier, and charging guideline.

13.Obtain and maintain up-to-date proficiency in Epic applications related to charges and charge edits.

14.Actively participate in Revenue Integrity Committee and provide supporting information.

15.Perform other duties as assigned.

16.Follow North Oaks Health System’s compliance programs and all Federal and State Regulatory guidelines.