Manager Revenue Integrity - FT - Days - MHS - Remote Eligible at Memorial Healthcare System

Job description

Location: Fort Lauderdale, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: The Revenue Integrity Manager provides operational leadership for Revenue Integrity functions, overseeing staff and workflows to ensure accurate, compliant, and timely charge capture, billing readiness, reimbursement optimization, and revenue protection across the health system. Responsibilities: Manages and monitors staffing activities including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.Periodically tests samples of departmental charges to evaluate whether staff members are performing correctly, and controls are operating as designed. Works with RCM and departmental staff to provide as-needed retraining as well as regular periodic updates for all charge capture staff.Monitors and provides training, support and troubleshooting to both application teams and end-users to facilitate proper usage and continuous learning. Manages applications projects including workflow analysis, end-user validation, acceptance, go‑live, and maintenance using standard project management methodology. Sets project deadlines and deliverables for specific modules and analysis. Manages the debugging and enhancements processes including the design and upgrades to existing systems in order to ensure up‑to‑date and reliable functionality.Utilizes subject matter expert skills to assist MHS leaders with analyses of billing, coding, and documentation requirements for payer coverage and payment of services affecting their service lines and initiatives.Designs and evaluates the tools and processes used to capture charges in each MHS department. Updates the design of tools to empower departmental staff to accurately post charges efficiently, without rework. Designs and implements controls to empower departmental leaders to ensure staff have captured charges accurately and timely. Ensures Epic charge-related work queues are timely and correctly cleared.Selects opportunities identified by team to implement and improve existing processes using information technology and ensures alignment with strategic initiatives of the organization.Manages the planning of application development and deployment; educates and promotes adherence to the organization's software compliance standards within the team.Strategic focus: based on regulatory and industry updates, MHS strategic initiatives, end-user feedback, and other information, identifies and achieves opportunities to improve charge capture efficiency and accuracy, eliminate missed charges, eliminate billing rework, and improve MHS net revenue.Keeps current, timely reads, and analyzes Medicare, Medicaid, and other technical guidance to determine how they affect Memorial Healthcare System (MHS) capture. Develops, recommends, and implements plans to comply with regulatory updates as approved by the Director of Revenue Integrity and in collaboration with responsible MHS leaders.Develops annual CDM CPT/HCPCS updates and implements as approved by the Director of Revenue Integrity. Includes working with operational departments to identify applicable new or revised codes. Oversees the maintenance of CDM-driven CPT/HCPCS coding requirements. Develops annual CDM Fee Schedule updates and implements as approved by the Director of Revenue Integrity. Updates Price Transparency Standard Charges file in accordance with regulatory requirements. Competencies: ACCOUNTABILITY, ACCURACY, ANALYSIS AND DECISION MAKING, CUSTOMER SERVICE, DEVELOPS RELATIONSHIPS, EFFECTIVE COMMUNICATION, ORGANIZATION SKILLS, PRODUCTIVITY, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, TEAM WORK Education and Certification Requirements: BachelorsEpic Charge Router Certification (EPIC CHG ROUTER) - EPIC Certification (