Job Description:
The Revenue Integrity Senior Manager is responsible for the strategic leadership and direction supporting initiatives preventing revenue leakage, accelerating cash flow, and maximizing reimbursement of services by evaluating the strategy, operations, and performance of the following functional areas: Professional/Facility Charge Capture, EPIC All Procedure(EAP), Strategic Pricing, Pricing Transparency, Denials Management, Reporting and Analytics.
Education Qualifications:
Key Responsibilities:
Oversees process improvement efforts to support compliance and to optimize net revenue within the functional areas of Revenue Integrity, and Revenue Services Analytics including:
Chargemaster - EPIC All Procedure (EAP) – Oversees the EPIC All Procedure (EAP) Master is maintained, compliant and new codes are entered timely, priced appropriately, and any pre-bill edits are worked timely
Strategic Pricing – Oversees and provides direction into system-wide annual pricing models and ad hoc pricing changes and presents impact to senior leadership
Pricing Transparency – Defines, develops, and leads the pricing transparency efforts with multiple departments to ensure the Essentia Health website files, and pricing posters are fully compliant with pricing transparency regulations
Denial Management – Oversees and provides system direction into Denial Management strategies, and presents results to senior leadership
Revenue Services Analytics – Collaborates with Revenue Services Analytics Manager and Enterprise Analytics Manager to ensure cross-training opportunities are maximized to support data requests
Identifies trends across functional areas and coordinates integrated collaboration and issues resolution initiatives
Negotiates vendor contracts and monitors performance to ensure contract terms are being met
Identifies opportunities for system or process improvements and drive change through targeted initiatives
Manages and oversees Revenue Integrity Department work, provides technical, specialized leadership and guidance in coordinating projects and managing deliverables, and serve as a resource for ad-hoc problem resolution and troubleshooting
Commits to team development, communication, and quality improvement throughout Revenue Integrity and Revenue Services Analytics
Educational Requirements:
- Bachelor’s degree required with a preference in Healthcare Administration, or other related field of study
Required Qualifications:
- 5 years hospital revenue cycle or reimbursement experience including seven 3 years Management experience supporting data management and data analysis, Revenue Services workflows, payer reimbursement, and claim coding, strong understanding of medical terminology
Employee Benefits at Essentia Health: Health Coverage: Medical, dental, vision, life and disability insurance, plus supplemental health benefit options to ensure employees' well-being.Retirement Savings Plans: 401(k) with employer contributions to support long-term financial security.Professional Development: Opportunities for career growth through training, tuition reimbursement, and educational programs.Work-Life Balance: Flexible scheduling, time off, holidays, and personal leave to help employees manage their professional and personal lives.Employee Wellness Programs: Initiatives focused on physical, mental, and emotional health, including fitness memberships, counseling services, and wellness activities.Eligibility for Essentia Health’s benefit programs vary. Please refer to the benefit summary provided to you, or contact our HR Service Center at (218) 576-0000 for more information.
Job Location: Business Service Center
Shift Rotation: Day Rotation (United States of America)
Hours Per Pay Period: 80
Compensation Range: $105768 - $158662 / year
FTE: 1
It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.