Manager Revenue Integrity

NEW HAVEN, CT
Oct 15, 2019

Share:
This job has no Apply URL.

Job Description

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The Revenue Integrity & Optimization Manager is responsible for identifying and developing strategies which will optimize reimbursement across the Yale New Haven Health System. With support from key areas throughout the Delivery Networks, this position will recommend and coordinate implementation of process improvements, revenue enhancement initiatives for the revenue cycle, and educating departments, clinicians and revenue cycle participants on coding, billing and reimbursement regulations to ensure appropriate reimbursement in a compliant manner.

EEO/AA/Disability/Veteran

Responsibilities

  • 1. Manage system charge capture / nurse audit teams, on all projects and assignments.
  • 2. Manage an enhanced business practice model that supports appropriate reimbursement and compliant charge capture processes.
  • 3. Improve systems net revenues, revenue compliance and cash collections by optimizing the system wide revenue cycle. Lead the team to ensure revenue, billing, charging and coding compliance through education of hospital personnel on current and changing regulations.
  • 4. Work collaboratively with the Charge Description Master Manger to ensure CDM is updated to reflect appropriate coding and billing guidelines as well current insurance contracts.
  • 5. Participate collaboratively with System Billing Office, EPIC HB, and Denials Management teams in the development, execution and follow-up of education programs for the healthcare system on all issues related to the revenue cycle.
  • 6. Develop and maintain collaborative working relationships with revenue producing departments, information systems personnel and clinical services.
  • 7. Act as a liaison between clinical and finance departments when new service lines are created or regulations are updated that affect current service lines.
  • 8. Perform on-site analysis of processes and Revenue Cycle Management as well as conducting follow up analysis of post-implementation operations.
  • 9. Perform charge capture audits.
  • 10. Identify root causes of charging practices and deficiencies to effectively address changes needed.
  • 11. Perform defense audits upon notification of external governmental audits.
  • 12. Follow up on issues uncovered during internal or external audits.
  • 13. Provide coding expertise for all compliance and reimbursement issues.
  • 14. Maintain up-to-date knowledge of regulatory (federal, state, and third party payer ) requirements and changes impacting charging practices.
  • 15. Perform all other duties as assigned.

Qualifications

EDUCATION


Bachelor?s degree in Finance, IT or related field is required. Master's Degree preferred.


EXPERIENCE


A minimum of 5 years of progressive experience working in a Revenue, Billing and/or Finance discipline within a healthcare setting.


LICENSURE


RN License, Coding Certification or Epic Resolute Certification preferred.


SPECIAL SKILLS


Excellent verbal and written communications skills. Strong computer skill with the ability to work independently and meet crucial deadlines. Ability to perform multiple tasks within time frame. Excellent interpersonal skills with the ability to relate well, communicate effectively, and interact with all levels of management, employees and outsiders. Strong analytical and interpretive skills. Current knowledge of reimbursement requirements necessary for Third Party payers including Medicare, Medicaid, and Commercial plans. Knowledge of medical coding, billing and Federal/State regulations.


Share:
This job has no Apply URL.
 

Not ready to apply, but interested in working at Yale New Haven Health?

Join our Talent Network

Job Info

Job: 10644

Department: Revenue Management
Category: MGMT/LEADERSHIP
Sub Category: 1ST LEVEL MGR (MGR/SUP)
Status: Full Time Benefits Eligible
Shift: D
Hours: 40

Similar Jobs

Assistant Patient Services Manager - MICU

NEW HAVEN, CT
MGMT/LEADERSHIP

Asst Manager Clinical Operations

NEW HAVEN, CT
MGMT/LEADERSHIP

Supervisor, Outpatient Coding

NEW HAVEN, CT
MGMT/LEADERSHIP

Off Shift Nurse Manager-Per Diem

Bridgeport, CT
MGMT/LEADERSHIP

Performance Manager, Post Acute

Milford, CT
MGMT/LEADERSHIP

REGISTERED NURSE-Milford Urgent Care Center

Bridgeport, CT
MGMT/LEADERSHIP

ASSISTANT NURSE MANAGER-Main Operating Room

Bridgeport, CT
MGMT/LEADERSHIP

Practice Supervisor

Bridgeport, CT
MGMT/LEADERSHIP

APP Clinical Manager - Neuroscience

NEW HAVEN, CT
MGMT/LEADERSHIP

PSM Ortho 7-7

NEW HAVEN, CT
MGMT/LEADERSHIP

Senior Manager - Budget

New Haven, CT
MGMT/LEADERSHIP

Manager Accreditation & Regulatory Affairs

New Haven, CT
MGMT/LEADERSHIP

Asst Patient Svcs Mgr/Csm, SRC Pre and Post Op

NEW HAVEN, CT
MGMT/LEADERSHIP

Quality and Safety Manager

Stratford, CT
MGMT/LEADERSHIP

Ops Coord Strategy & Prog Dev

NEW HAVEN, CT
MGMT/LEADERSHIP

Director of Nursing-Emergency Department

Bridgeport, CT
MGMT/LEADERSHIP

RN-Off Shift Administrative Mgr

Bridgeport, CT
MGMT/LEADERSHIP

Practice Supervisor

NEW HAVEN, CT
MGMT/LEADERSHIP

Manager Revenue Integrity

NEW HAVEN, CT
MGMT/LEADERSHIP

PSM SLA3

NEW HAVEN, CT
MGMT/LEADERSHIP

Day Shift Supervisor

NEW HAVEN, CT
MGMT/LEADERSHIP