Manager Revenue Integrity

• Supervises, trains, and develops Revenue Integrity team members to ensure effective performance and adherence to best practices in revenue cycle operations.
• Oversees the management and maintenance of the Charge Description Master (CDM) to ensure accuracy, compliant effective and efficient operations. Work to implement strategies to improve charge capture and prevent revenue leakage.
• Develops CDM-related departmental, division and/or organizational policies and procedures for recommendation and approval including but not limited to pricing, CDM audits, charge reconciliation, and charge capture. Create and execute work plans to successfully implement changes to systems and/or process as necessary.
• Leads efforts of multidisciplinary groups where necessary to monitor the completeness and accuracy of revenue and billing information.
• Leads organization RAC Denials team and works closely with the Patient Financial Services ("PFS") to track and monitor coding-related denials.
• Coordinates and/or participates in system testing as a result of upgrades, changes, enhancements, new application implementations, etc. that may impact the CDM, charge capture and/or charge data flow between systems or modules.
• Analyzes financial and clinical data to identify trends, revenue improvement opportunities, and potential risks. Monitor key performance indicators (KPIs) and provide regular reports on revenue integrity performance.
• Partners with finance, billing, compliance, and revenue cycle to develop strategies and ensure alignment across departments.
• Actively promotes and participates in initiatives to improve organization effectiveness and efficiency.
• Works with departmental managers to ensure that clinical charges and billing codes are fully and correctly established in Electronic Medical Record patient care applications and are captured by Electronic Medical Record patient billing applications. Provides education as needed to departments related to their charges and charging practices
• Regularly attends and actively participates in staff meetings, in-services and continuing education programs as offered in order to remain current with organizational and industry changes. Communicate and disseminate information to other departments as applicable.
• Successfully maintains staff engagement and satisfaction scores for responsible departments based on periodic internal surveys at or above the stated organizational goal.
• Role models the principles of a Just Culture and Organizational Values.
• Must be HIPAA compliant

• Five years healthcare-revenue cycle experience required, including two years in Revenue Integrity.
• Prior supervisory experience preferred.
• Demonstrated knowledge of laws and regulations pertaining to healthcare industry required.
• Prior healthcare financial experience or related field experience in a hospital/integrated healthcare delivery system preferred.
• Prior CDM or charge capture experience required.
• Proficiency in medical terminology, hospital charge masters, charge review, clinical record information systems, and coding methodologies required
• Prior experience leading and managing complex projects

• Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC/CPC-H), Certified Coding Specialist (CCS/CCS-P), Certification in Healthcare Revenue Integrity (CHRI), Certified Revenue Cycle Representative (CRCR), Certified Revenue Cycle Professional (CRCP) or other HIM related certification preferred.

• Bachelor’s degree required or higher preferred; related experience may be considered in lieu of degree.

The posted salary range for this position applies to Colorado and may be adjusted based on geographic location. Vail Health considers a variety of factors in making compensation decisions, including but not limited to experience, education, licensure and/or certifications, geographic location, market demand and other business and organizational needs.