Revenue Integrity Operations Supervisor

About The Wilshire Group 

The Wilshire Group, a renowned boutique consulting firm in Los Angeles, specializes in revenue cycle optimization and fostering effective collaboration between operational and IT facets.  With a robust track record of aiding over 100 healthcare systems nationwide, our team thrives on professionalism, efficiency, and adaptability.

Our core values- professionalism, efficiency, and flexibility- underscore our commitment to creating an inclusive and dynamic workplace.  We embrace diverse narratives and believe in offering opportunities to exceptional individuals who bring their best to the table.

We are currently offering a contracted interim position at one of US News Best Hospitals 2022-23.  This position caters to top performers seeking a professional environment that acknowledges and values their dedication and proficiency.  While this role doesn’t offer benefits, it presents an opportunity to work within an organization that encourages talented individuals to surpass conventional boundaries.

Join us at The Wilshire Group, a place where talented professionals find a home to showcase their skills and contribute meaningfully to the healthcare landscape.

Why Wilshire? Employee Testimonial

“The number of RCM subject matter experts I get to work with each day is unreal.  Working alongside and as part of this team to help shape the RCM space is exciting.”-Patti Consolver, Director of Business Development 

This is a contracted position for 6+ months.  This position offers 65% of fee sharing.  Equivalent to $75-$100 per hour.

Revenue Cycle Operations Supervisor

Position Summary:

The Revenue Integrity department has systemwide responsibilities for charge capture integrity for both hospital and professional services. The incumbent serves as an expert in quality assurance of design, development, and application of integrated charge capture systems and programming designed to bridge health informatics with charge capture, billing requirements, and workflow for optimal efficiencies and to secure reimbursement. Incumbent provides detailed and in-depth analysis, quality assurance, reporting consultation, and recommendations in support of revenue cycle management functions including programming modifications, clinical interpretations and education, audit, and analysis. Incumbent regularly interacts with all levels of management and staff to provide education and training on necessary documentation, interpretation, system applications, reporting capabilities, and modifications to workflow for appropriate charge capture and facilitate accurate reimbursement. Provides supervisory duties for the department.

Required Qualifications:

-Minimum 5 years in a leadership/supervisory position in a Revenue Integrity or Revenue Cycle role.

-Strong knowledge of healthcare revenue cycle operations, concepts, and policies and their impact throughout the organization, with an in-depth understanding of related functions and issues including coding, registration, billing, reimbursements, aging accounts, contractual adjustments, and charge capture; experience with both facility and physician provider charging and coding

 -Ability to establish and maintain effective working relationships across the Health System -Ability to maintain a work pace appropriate to the workload

 -Excellent written and verbal communication skills in English

-Knowledge and understanding of interface communication systems and data transmission

-CPC, COC, or CPMA Certification or coding certification equivalent.

 -Must demonstrate high-level analytical skills

-Demonstrated ability to work in a team environment

-Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties

 -5 years of internal and/or external auditing experience.

-Familiarity with software packages.

-Demonstrated customer service skills Preferred Qualifications:

-Epic Certified in Resolute applications

-Recent acute care hospital experience and ambulatory outpatient clinic experience

 -Recent acute hospital experience

-Knowledge of California's healthcare environment

-Familiarity with Microsoft Office Products

 -Working knowledge of academic healthcare center policies and procedures related to revenue cycles