Revenue Integrity Manager (Remote)

Envision Radiology is adding a Remote Revenue Integrity Manager to the team!

Monday - Friday 8:00AM - 5:00PM | Position Pay Range $69,500 - $86,850

The Revenue Integrity Manager is responsible for the timely and accurate capture of patient service revenue. The Revenue Integrity Manager acts as a liaison between Revenue Cycle Operations and Information Systems to improve processes, increase accuracy, create efficiencies, and achieve key performance metrics targets. The position is responsible for researching reimbursement and regulatory variance issues and providing analyses. The Revenue Integrity Manager must have the ability to review, analyze, and interpret insurance contracts, government regulations, and other non-contracted reimbursement methods. The position manages EFT, ERA enrollments and system mappings for automation of file imports. It also leads the transition of payers from paper checks or manual portals to Electronic Remittance Advice (ERA), including handling the necessary paperwork, processing, and ensuring a smooth transition to more efficient electronic payments. Responsibilities include receivables management, general ledger reconciliation, operational processes, report writing, and system integration.

Essential Functions

1. Manage an enhanced business practice model that supports reimbursement and compliant charge reconciliation processes.
2. Improve reconciliation systems and revenue compliance through analysis on current processes. Participate in or lead projects aimed at improving the revenue cycle process, including software implementations, operational enhancements, or billing system upgrades.
3. Develop and maintain collaborative working relationships with revenue producing departments, Data Analytics, and information systems personnel.
4. Develop and maintain strong partnerships with third party vendors which support billing, payments, and clearinghouse processes. Utilize vendor ticketing systems to address and resolve issues.
5. Identify missing and/or misallocated payments and provide resolutions.
6. Maintain internal and external financial reconciliation systems while ensuring the accuracy of the financial data and reporting.
7. Maintain up-to-date knowledge of healthcare regulations affecting billing, privacy, and electronic transactions, ensuring all processes comply with HIPAA and other relevant standards.
8. Ensure month end processing is completed within required deadlines, prepare Reconciliation reports and balance to general ledger.
9. Perform ongoing trend analysis of payer rejections and denials. Work with Revenue Cycle Management to perform proactive review of all recommended AR write-offs.
10. Prepare monthly and annual reporting related to net revenue, revenue deductions, charity, and bad debt.
11. Support Accounting and Revenue Cycle with annual financial audits.
12. Other duties as assigned.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Competencies

1. Ethical Conduct.
2. Leadership
3. Organization Skills.
4. Financial Management.
5. Problem Solving/Analysis.
6. Strategic Thinking.
7. Communication Proficiency.

Supervisory Responsibilities

This position provides daily leadership to the supporting staff. This position is also involved in the performance management and hiring of the employees within the department.

Work Environment

This job operates remotely and must adhere to the work at home requirements. There may be travel required for Leadership Training, onsite center visit, and/or center collaboration.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to use hands and fingers to handle, feel or operate objects, tools or controls, and reach with hands and arms. The employee is frequently required to talk and hear.

Travel

Some travel is expected for this position.

Job Qualifications

Minimum Qualifications/Experience:

• Three to five years' experience in healthcare billing management or healthcare finance, specifically managing revenue cycle, billing, or reimbursement processes.
• Ability to analyze and resolve complex application systems problems and provide resolutions and/or recommendations.
• Knowledgeable in healthcare billing terminology, computer systems healthcare financial management software and interfaces.
• Superior analytical and reporting skills to manage financial data and provide insights for operational improvements.
• Capable of establishing effective working relationships that promote teamwork and collaboration.
• Excellent written and verbal communication skills, and ability to interact effectively with various levels of staff, management, and external finance partners.

Education/Certifications:

• Bachelor's degree in Business, Finance, Healthcare or related field preferred, or equivalent combination of education and experience.

Additional Eligibility Qualifications

None required for this position.

Compliance

Adheres to Envision's Code of Conduct and Compliance Policies and attends annual Compliance training as set forth by the Company.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Other duties may be assigned as needed by supervision.

Company Benefits

Below is a list of benefits that are offered to employees once eligibility is met.

• Health Benefits: Medical/Dental/Vision/Life Insurance
• Company Matched 401k Plan
• Employee Stock Ownership Plan
• Paid Time Off + Paid Holidays
• Employee Assistance Program

OSHA Exposure Rating: 1

It is reasonably anticipated NO employees in this job classification will have occupational exposure to blood and other potentially infectious body fluids.

Envision Radiology is an equal opportunity employer (M/F/D/V). We recruit, employ, train, compensate and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, veteran status, or any other basis protected by application federal, state or local law.

Applications accepted until 3/8/2024