Hybrid Manager, Revenue Integrity

at Connecticut Children's

• Job title: Manager, Revenue Integrity
• Job type: Full Time
• Experience level: Senior, Lead
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, East Hartford, United States

About the role

• Manager of Revenue Integrity at Connecticut Children’s optimizing workflows and ensuring accurate documentation, charges, and coding in collaboration with clinical service lines. Responsible for analysis and recommendations for revenue cycle departments.

Responsibilities

• Optimize workflows and related information systems to ensure accurate, complete, timely documentation, charges and coding of services
• Maintain extensive knowledge of all aspects of the revenue cycle including registration, documentation, coding, billing and collection processes
• Analyze and assess diverse data relating to the revenue cycle
• Provide essential quality reports and improvement recommendations to management for all clinical service lines and revenue cycle departments

Requirements

• Bachelor’s degree in Healthcare related field, Master’s Degree Preferred
• Associate’s degree with 10+ years’ experience directly related to healthcare and Revenue Integrity in lieu of a Bachelor’s degree
• Seven years minimum recent and direct related experience
• Previous management experience in Clinical service area(s), Revenue Integrity, Revenue Cycle Area(s)
• Strongly Preferred: Previous clinical experience
• Active Certified Coding Specialist (CCS) and/or Certified Professional Coder and/or Certified Outpatient Coder and/or Hospital (CPC-H) (or attainment within one (1) year of hire)
• Preferred: Dual Certifications i.e., CPC and CCS
• Extensive clinical coding knowledge; clinical experience preferred
• Solid understanding of the reimbursement systems including IPPS, OPPS, DRG, etc.
• State and federal and third party payer regulations
• CPT/HCPCS/ ICD classification, medical terminology, billing and reimbursement processes
• Extensive knowledge of charge creation, processing and reconciliation in a health care environment
• Strong quantitative, analytic, and problem-solving skills
• Strong organizational skills
• Strong time management, attention to detail, and follow through
• Excellent interpersonal and communication skills
• Microsoft Office, Outlook, Excel; Epic experience highly desirable
• Well developed, formal presentation skills
• Ability to effectively collaborate with providers and staff at all levels
• Manage day to day operations managing staff and ensuring efficient workflows
• Analyze and interpret billing guidelines, state, federal and third party payer regulations
• Organize resources and establish priorities
• Develop, plan and implement short and long-range goals
• Foster a cooperative work environment
• Effectively manage staff, ensure employee development and oversee performance management

Benefits

• Health insurance
• Pension plan
• Vacation time
• Professional development opportunities
• Flexible working arrangements