Manager, Revenue Integrity

Who We AreJPS Health Network is a $950 million, tax-supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospital a Level I Trauma Center, Tarrant County's only psychiatric emergency center, and the largest hospital-based family medical residency program in the nation. The health network employs more than 7,200 people.

Acclaim Multispecialty Group is the medical practice group featuring over 300 providers serving JPS Health Network. Specialties range from primary care to general surgery and trauma. The Acclaim Multispecialty Group formed around a common set of incentives and expectations supporting the operational, financial, and clinical performance

outcomes of the network. Our goal is to provide high quality, compassionate clinical care for every patient, every time.

Why JPS?We're more than a hospital. We're 7,200 of the most dedicated people you could ever meet. Our goal is to make sure the people of our community get the care they need and deserve. As community stewards, we abide by three Rules of the Road:

1. Own it. Everyone who wears the JPS badge contributes to our journey to excellence.

2. Seek joy. Every day, every shift, we celebrate our patients, smile, and emphasize positivity.

3. Don't be a jerk. Everyone is treated with courtesy and respect. Smiling, laughter, compassion - key components of our everyday experience at JPS.

When working here, you're surrounded by passion, diversity, and dedication. We look forward to meeting you!

For more information, visit www.jpshealthnet.org.

To view all job vacancies, visit www.jpshealthnet.org, www.jpshealthnet.org/careers, or www.teamacclaim.org.

Job Title:

Manager, Revenue Integrity

Requisition Number:

30348

Employment Type:

Full Time

Division:

HEALTH INFORMATION MANAGEMENT

Compensation Type:

Salaried

Job Category:

Director / Management Level

Hours Worked:

8-5 (M-F)

Location:

John Peter Smith Hospital

Shift Worked:

Day

Job Description:

Job Summary: The Manager Revenue Integrity is responsible for managing the daily functions of the Revenue Integrity team. They are responsible for functions related to the build and maintenance of the Charge Description Master (CDM) as well as enterprise Charge Capture. This Manager must possess and maintain advanced knowledge of the CDM build and maintenance process within EPIC. This manager is also responsible for the analysis and assessment of diverse data related to the revenue cycle. The Manager Revenue Integrity plays a leadership role in a high-profile group tasked with improving/maintaining revenue results by taking a global view of clinical and financial processes, functions, and interdependencies from the provision of patient care to final bill generation. They will provide essential quality reports, advice, and improvement recommendations to management along all service lines. Required to understand and communicate complex issues and changes relating to regulatory compliance and third-party reimbursement to the department(s) involved, maintain records of their notification, accountability and compliance.

Essential Job Functions & Accountabilities:

1. Manages audit program identifying opportunities and utilizes information obtained from these audits to develop revenue integrity education programs.
2. Provides oversight of work queues including: Development of dashboard for reporting identified opportunities for charging, documentation, and coding. Tracks and trends work queues to show performance improvement initiatives with return on investment
3. Manages oversight of the charge description master (CDM) which includes review of updates/changes to CDM by regulatory bodies. Acts as a resource to revenue generating departments in establishing new charges including; education regarding appropriate interpretation of CPT codes, HCPCS codes, and Revenue codes. Reviews and approves changes in pricing, CPT codes, HCPCS codes and Revenue codes for accuracy and compliance to all applicable billing guidelines. Coordinates and works with outside consultants regarding all charge master reviews, maintenance, and refinements.
4. Determines the reimbursement impact of CPT revisions as well as charge additions and deletions with feedback to affected service lines.
5. Identifies and assists with establishing controls ensuring compliance and achievement of financial goals (i.e. appropriate internal controls).
6. Identifies gaps in process that contribute to missed, inaccurate, or late charges.
7. Provides guidance, communication and education on correct charge capture, coding and billing processes to multiple clinical departments and facilities
8. Works with department managers to develop and implement policies and procedures for purposes of reconciling charges.
9. Functions as the liaison between departments, Information Technology, and Revenue Integrity with the goal of creating efficient charge generation processes that promote timely charge capture and billing required to expedite the reimbursement process. Will identify charge generation process between EPIC and the end-users.
10. Leads and participates in complex projects related to revenue integrity initiatives collaborating with Compliance, Finance, Patient Financial Services, Health Information Management & clinical departments as needed.

Qualifications:

Required Qualifications:
• Bachelor's degree in Health Information Management, Business, Finance, Accounting or related field.
• Two (2) plus years of experience in a relevant management or supervisory role.
• Three (3) plus years of healthcare coding experience.
OR
• Associate's Degree in Health Information Management, Business, Finance, Accounting or related field.
• Five (5) plus years of healthcare coding experience.
• Three (3) plus years of experience in a relevant management or supervisory role.
AND
• AHIMA certification (e.g. RHIA, CCS, RHIT); AAPC certification (e.g. CPC, CPH, CA) or applicable clinical or professional certifications/licenses such as RN, RT, MT, RPH, ARRT required Experience of the information systems used in the billing and collection process.
• Experience with financial statements and ability to analyze financial information and determine financial impact of possible changes.
Preferred Qualifications:
• Five (5) plus years of progressively responsible revenue cycle experience involving charge master, revenue integrity, quality assurance and/or auditing activities to include leading people, projects, or programs.
• Five (5) plus years of experience working with Epic and 3M coding applications. Epic certification or willingness to be certified.

Location Address:

1500 S. Main Street

Fort Worth, Texas, 76104

United States