|Type:||FULL TIME, OTHER
|Job Location:||Partial Remote
|Skills:||Revenue cycle experience
|Required Experience:||5 to 7 years
|Preferred Experience:||5 to 7 years
|Location:||4755 Ogletown Stanton Rd Newark 19718, DE, US
ChristianaCare is searching for a Revenue Integrity Team Lead to join our Medical Audit team and will manage, coordinate, and implementing complete, correct, timely and compliant charge capture initiatives and processes. This position will handle reviewing and interpreting Managed Care contracts, and Government fee schedules and regulations to ensure appropriate reimbursement.
When you become an employee at ChristianaCare, you are joining a healthcare organization that was named Forbes 5th Best Health System to Work for in the U.S. for 2021! Guided by excellence and love, our Caregivers enjoy many employee benefits such as
PRINCIPLE DUTIES AND RESPONSIBILITIES:
- Conducts root-cause analyses with Revenue Integrity Analysts to identify opportunities for error reduction.
- Conducts audits and reviews activities to improve the revenue cycle, claims production and coding integrity. Reviews data and systems to target areas of improvement.
- Serves as a subject matter expert and in a consultative role to various levels of customers; works closely and collaboratively with Clinical Department Leaders.
- Maintains knowledge of and organizational compliance with state, federal, and other third-party payer billing and reimbursement guidelines.
- Responsibilities include all aspects of Revenue Cycle support including performance improvement, development, documentation, testing, training and upgrades. Assist management in examining processes to improve workflow.
- Reviews, monitors, and facilitates implementation of billing and coding changes affecting charge capture processes in accordance with payer requirements.
- Provides guidance and education to billing and clinical department staff related to appropriate
- documentation requirements, denials resolution, and regulatory requirements relevant to charging, coding and billing.
- Compiles and analyzes data from various sources to develop recommendations leading to potential revenue cycle opportunities, including analyses related to CDM set-up, charge capture, billing and/or patient financial services.
- Conducts and leads special projects to facilitate revenue management as required for new facilities/acquisitions, new departments, new service lines, changes in regulations, etc.
- Implements charge capture corrective measures and monitoring tools to ensure sustainability of changes; performs, reviews, and monitors statistics and key performance indicators to identify improvement opportunities.
- Maintain current knowledge in present areas of responsibility (i.e., self-education, attends ongoing educational programs).
- Develop and maintain tracking reports.
- Articulate thoughts and ideas effectively both verbally and in writing.
- Present information effectively in a variety of settings: one-on-one, small and large groups, with peers, direct reports, and superiors.
- Document all procedures and activities timely, accurately, and legibly.
- Demonstrates the highest level of confidentiality and conducts self according to AHIMA Code of Ethics.
EDUCATION AND EXPERIENCE REQUIREMENTS:
Bachelor's degree from an accredited college in a relevant field of study.
Equivalent and relevant combination of education and experience may be considered in lieu of Bachelor's degree.
Five years of revenue cycle management and/or revenue integrity experience in a healthcare environment.