Manager, Revenue & Charge Integrity

City/State

Norfolk, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara Health is seeking to hire a qualified individual to join our team as a Manager, Revenue & Charge Integrity

Position Status: Full-time, Day Shift

Position Location:

Position Summary: 

The Revenue/Charge Integrity manager leads a high-profile group responsible for ongoing maintenance and development of the charge description master (CDM) for all Sentara hospital facilities as well as Sentara Physician Groups, and charge capture structures/methodologies in Epic. Ensure that all items on the CDM are a direct reflection of chargeable/billable services.

This role requires a comprehensive understanding of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) guidelines and Medicare regulatory guidelines, as well as the understanding of Epic build and its related charge capture processes 

Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills combined with superb analytic and organizational abilities. The ability to meet deadlines while influencing but not directly managing the work of others is necessary. 

Principal Duties and Responsibilities:

•    Manage Revenue Integrity staff, as assigned.
•    Initiate, coordinate, and implement all code and charge capture changes 
•    Recruit, mentor and coach Revenue Integrity staff at various levels of development.
•    Lead and participate in complex projects related to revenue cycle initiatives.
•    Collaborate with various departments throughout Sentara to integrate code and charge capture related functions and communicate changes to impacted teams
•    Ensure that all charge documents and charge capture systems are updated to allow for accurate coding and charge capture.
•    Communicate and coordinate training for charge processing changes to clinical departments
•    Execute post implementation audits on chargemaster changes
•    Perform quality audits related to analyst work product.
•    Develop, maintain and implement department training materials. 
•    Develop, maintain and implement a Quality Audit Program and associated reporting.
•    Work with Patient Accounting to ensure denials and billing errors related to the code and charge capture are addressed in a timely and accurate manner.
•    Keep current on coding and chargemaster related issues through monitoring of the regulatory environment, review of literature, participation in professional organizations and continuing education. 
•    Execute on decisions made using sound judgment in dealing with compliance and regulatory issues.
•    Develop and present recommendations for change. Obtain buy in from Administrative Directors and Physician Leaders.
•    Manage special projects, implementations, and department initiatives as assigned

Master's Level Degree preferred.

Standard Working Hours: 8:00AM to 5:00PM (ET).

Minimum Requirements:

• Bachelors Level Degree required
• 5 years Experience with EPIC EMR System
• 5 years experience Revenue Integrity/Charge Master/Revenue Cycle required.
• 3 years Healthcare required
• Clinical experience is desired. Registered Nurse is desired. Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification is desired.
• Requires some travel.

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 Sentara Overview
For more than a decade, Modern Healthcare magazine has ranked Sentara Health as one of the nation's top integrated healthcare systems.  That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.

Sentara Benefits
As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers.  We offer a variety of amenities to our employees, including, but not limited to: 

 Medical, Dental, and Vision Insurance

• Paid Annual Leave, Sick Leave
• Flexible Spending Accounts
• Retirement funds with matching contribution
• Supplemental insurance policies, including legal, Life Insurance and AD&D among others
• Work Perks program including discounted movie and theme park tickets among other great deals
• Opportunities for further advancement within our organization

Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace.  For information about our employee benefits, please visit: Benefits - Sentara (sentaracareers.com)

Please Note: The yearly Flu Vaccination is required for employment.

Note: Sentara Health offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability, and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.

Job Summary

The Revenue/Charge Integrity manager leads a high-profile group responsible for ongoing maintenance and development of the charge description master (CDM) for all Sentara hospital facilities as well as Sentara Physician Groups, and charge capture structures/methodologies in Epic. Ensure that all items on the CDM are a direct reflection of chargeable/billable services. This role requires a comprehensive understanding of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) guidelines and Medicare regulatory guidelines, as well as the understanding of Epic build and its related charge capture processes

Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills combined with superb analytic and organizational abilities. The ability to meet deadlines while influencing but not directly managing the work of others is necessary.

Principal Duties and Responsibilities:

• Manage Revenue Integrity staff, as assigned.
• Initiate, coordinate, and implement all code and charge capture changes
• Recruit, mentor and coach Revenue Integrity staff at various levels of development.
• Lead and participate in complex projects related to revenue cycle initiatives.
• Collaborate with various departments throughout Sentara to integrate code and charge capture related functions and communicate changes to impacted teams
• Ensure that all charge documents and charge capture systems are updated to allow for accurate coding and charge capture.
• Communicate and coordinate training for charge processing changes to clinical departments
• Execute post implementation audits on chargemaster changes
• Perform quality audits related to analyst work product.
• Develop, maintain and implement department training materials.
• Develop, maintain and implement a Quality Audit Program and associated reporting.
• Work with Patient Accounting to ensure denials and billing errors related to the code and charge capture are addressed in a timely and accurate manner.
• Keep current on coding and chargemaster related issues through monitoring of the regulatory environment, review of literature, participation in professional organizations and continuing education.
• Execute on decisions made using sound judgment in dealing with compliance and regulatory issues.
• Develop and present recommendations for change. Obtain buy in from Administrative Directors and Physician Leaders.
• Manage special projects, implementations, and department initiatives as assigned

Master's Level Degree preferred. 5 years Experience with EPIC EMR System and 5 years experience Revenue Integrity/Charge Master/Revenue Cycle required. Clinical experience is desired. Registered Nurse is desired. Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification is desired. Requires some travel.

Qualifications:

BLD - Bachelor's Level Degree (Required)

Healthcare, Revenue Integrity

Skills

Active Learning, Active Learning, Active Listening, Communication, Complex Problem Solving, Coordination, Critical Thinking, Judgment and Decision Making, Leadership, Learning Strategies, Mathematics, Mgmt of Financial Resources, Mgmt of Material Resources, Mgmt of Staff Resources, Microsoft Access, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, Monitoring, Operations Analysis, Persuasion, Project Management, Quality Control Analysis, Reading Comprehension, Science {+ 8 more}

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission “to improve health every day,” this is a tobacco-free environment.