• Senior Manager of Revenue Integrity

    Location US-MA-Brookline
    Job Posted Date 1 week ago(12/5/2018 3:19 PM)
    Job ID
    2019-13256
    Category
    Finance/Accounting/Patient Billing
    Type
    full time
    Grade
    24
  • Overview

    Leads and directs Revenue Integrity, Data Integrity, Clinical Trial Billing Review, Analytics teams to ensure effective and compliant revenue management and charge capture at DFCI. Coordinates and directs charge reconciliation activities, revenue monitoring, and the identification and deployment of charge capture improvement initiatives. Collaborates with the Information Services and CDM team to support enterprise charge capture activities Utilizes reporting tools and data analysis to gain operational insight into issues to identify and manage problems and propose resolutions. Supports development, implementation and compliance of Charge Capture policies and procedures necessary to support operations.

     

     Manages AR financial reporting, and ad-hoc reporting requests as well as provides support to analysts in researching issues and any analytical works. As a manager, establishes and maintains strong, collaborative relationships with all internal and external customers to identify additional ways to be of service and ensure customer satisfaction.  

     

    Responsibilities

    • Manages staff and works with clinical departments to ensure appropriate charge capture effectiveness and identifies and recommends opportunities for improved standardization and consistency of Charge Capture process system-wide
    • Assesses revenue generating departments, particularly those that are high volume, high revenue, and/or high risk to ensure accurate Charge Capture, and provides recommendations for Revenue Cycle process improvements
    • Analyzes and verifies charging procedure
    • Acts as subject matter expert for CDM/Charge Capture related issues
    • Participates in the changes of CDM/Charge Capture processes and systemsProvides operational guidance and support to assigned staff under the direction of the Sr. Director, Patient Financial Services, disseminates policy/procedure updates, and supports coverage of other departmental divisions, as required
    • Provides input to and/or drafts Policies/Procedures, communications and other business documentation; assists with special projects and prepares management reports
    • Manages the annual CPT/HCPCS code set changes. This includes collaborating with partner facilities on the work effort as well as working with DFCI service departments, Billing Compliance and Coding on reviewing the changes
    • Serves as a subject matter expert to assist with system/process setup for new services
    • Maintains the knowledge and understanding of business relationships and service arrangements between DFCI and partner facilities such as BWH and BCH for different services
    • Oversees functional or integrated testing of application updates, analyzes written and verbal feedback and communicates changes to staff in a manner that ensures compliance with DFCI CDM/Charge Capture standards
    • Provides function-specific training, including staff orientation, continuing education, and job aides to assist the staff in performing work assignments
    •  

     

    Qualifications

    • Prior supervisory.management experiecne required
    • Minimum of five (5) years Chargemaster, Hospital Billing and Patient Accounting experience; Bachelor’s Degree preferred
    • Knowledge of third-party payer reimbursement policies
    • Degree in Business preferred, however, can be substituted with ample industry experience
    • Experiences with revenue cycle operations
    • Knowledge of clinical system and billing system (Epic), and external claim scrubber system (XClaim), charge Capture processes and workflows
    • Additional duties as assigned.

    Knowledge, Skills, and Abilities Requirements:

    • Knowledge of chargemaster, patient accounting operations, third party policies, and industry standards
    • Excellent computer skills, including proficiency in Microsoft Office (i.e. Word, Excel)
    • Strong analytical background with ability to translate very technical information and findings to others
    • Well developed, formal presentation skills
    • CPT and HCPCS coding experience required; coding certification a plus
    • Excellent oral and written communication skills
    • Ability to navigate in a highly matrixed organization

    Leadership:

    • Identifies ways to improve work processes, enhance quality, productivity, and service delivery
    • Demonstrates commitment towards continuous improvement initiatives and willingness to challenge existing practices
    • Works with CDM/Charge Capture team to ensure the direction and successes of Charge Capture Support are well communicated
    • Provides technical support to fulfill CDM maintenance, reporting and data analysis requests
    • Works with other functional teams to enable new services
    • Ensures delivery of business results by meeting or exceeding service level agreements
    • Manages Charge Capture, Data Integrity and Clinical Trial Billing Team key performance indicators and metrics

     

    Relationship Management:

    • Promotes strong collaborative relationships between the department administration, IS, Charge Capture team and all other teams within the Revenue Cycle
    • Establishes and maintains strong, collaborative relationships with the Finance and CDM teams ensure a coordinated and cohesive work effort
    • Maintains a collaborative relationship with other groups related to Clinical Trial Billing

     

    Confidentiality Required:

    • Regular exposure to patient demographic, diagnostic and bill information
    • Exposure to physician information including physician numbers assigned by governmental agencies and insurance carriers


    Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other groups as protected by law.

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