Revenue Integrity Manager
Methodist Le Bonheur Healthcare
full-time
Posted on:
Location Type: Hybrid
Location: Memphis • Tennessee • United States
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About the role
- Plans, organizes, develops and implements revenue cycle operations to meet UT Le Bonheur Pediatric Specialists and departmental goals and objectives
- Maintains appropriate internal controls over front end billing functions, patient registration, pre-certification, procedure authorizations, insurance verification, charge entry and coding
- Keeps abreast of all reimbursement billing procedures of third party and private insurance payers
- Manages patient registration, pre-certification, procedure authorization, coding, and charge posting, advising supervisors on the day-to-day implementation and interpretation to ensure compliance with all policies and procedures
- Provides analysis with regard to financial impact of new MH ULPS business opportunities and decisions
- Manages, and controls development and implementation of product and procedure pricing for ULPS
- Promotes the flow of information by establishing, utilizing, and maintaining effective communication systems within and outside the department
- Develops, analyzes, and reviews special projects as necessary
- Manages the process of internal and external charge/chart audit
- Designs and implements training programs to ensure that all areas are adequately trained on charge capture and reconciliation policies and procedures
- Designs process to capture lost charges missed by ULPS billing areas to ensure maximum legitimate reimbursement for the services provided
- Maintains and develops a competent, productive, and quality conscious workforce by hiring, evaluating performance, counseling, training, issuing corrective action, and recommending promotion or discharge of department personnel according to the MH value
Requirements
- Bachelor's Degree Business Administration/Management
- In lieu of Bachelor's degree, a High School diploma with four (4) years equivalent experience in business practices, accounting and finance
- Ability to understand and prepare written materials, such as management reports and memos
- Ability to communicate verbally with all levels of Associates, senior management officials, and other outside professionals
- Strong quantitative problem solving abilities
- Ability to lead and motivate individuals and groups toward the accomplishment of work and organizational goals
- Ability to organize multiple tasks and projects and maintain control of workflow
- Ability to work without close supervision or guidance and exercise independent judgment
- Ability to facilitate education/training sessions at all levels of the organization.
Benefits
- Flexible work arrangements
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
revenue cycle operationsbilling functionspatient registrationpre-certificationprocedure authorizationinsurance verificationcharge entrycodingcharge postingfinancial analysis
Soft Skills
communicationleadershiporganizational skillsproblem solvingindependent judgmenttraining facilitationworkflow managementteam motivationperformance evaluationcounseling
Certifications
Bachelor's Degree in Business Administration/ManagementHigh School diploma with equivalent experience