Supervisor, Revenue Integrity

Responsibilities

• The Supervisor, Revenue Integrity leads the daily activities Revenue Integrity Analysts and Charge Auditors. Duties include but are not limited to ensuring timely and efficient charge entry for emergency room and other ancillary areas; completion of pre-billing workflows including Meditech Account checks and SSI claims edits; and post-billing/auditing and charge capture using Trisus Claims Informatics (TCI) or other tools. This position works directly with the Director and Project Manager to maintain compliance with contractual agreements and federal/state regulations.
  
  The Supervisor prioritizes open communication with coworkers; conducts monthly performance audits; and provides input on coworker performance. The Supervisor ensures processes are efficiently followed to meet timely charge entry standards, department key performance metrics (KPIs) and overall cash goals for the revenue cycle. The Supervisor provides coverage for co-workers as needed to maintain or improve KPIs and other duties and projects as assigned by the Revenue Integrity Project Manager or Director.

• Education

• 3-5 Years health care revenue cycle, revenue integrity, or related experience - Required
• Experience with healthcare claims submission, billing regulations including Centers for Medicare and Medicaid hospital requirements, charge entry, charge reconciliation and various pre and post claims edits - Required
• Experience with Excel spreadsheets, data analytics, and root cause analysis - Preferred
• Prior experience supervising operational work and/or co-workers - Preferred

• Certified Revenue Cycle Representative (CRCR), Certified Revenue Cycle Specialist (CRCS) or Certified Revenue Integrity Professional (CRIP) - Required or obtained within 1 year of date of hire
• Medical Coding certification such as COC, RHIT, CPC, or similar - Preferred

• Independently identifies workflow priorities, assigns and monitors work for the Revenue Integrity Analysts and Charge Auditors to ensure production standards and KPIs are met. Provides coverage for core job functions of the Revenue Integrity (RI) Analyst and Charge Auditor, as needed. Provides feedback on performance to coworker and Director including assisting with monthly performance audits.
• Trains department co-workers and others on charge capture, charge reconciliation, pre-bill auditing and claims scrubbing edit resolution. Monitors and trains co-workers on specific Craneware/Trisus modules/tasks including Trisus Reference and Trisus Claims Informatics;
  Meditech Expanse workflows; and SSI claim edits.
• Collaborates with others to implement process improvements including documentation opportunities, charge reconciliation, charge capture improvements; and possible updates to the charge description master (CDM). Facilitates discussions with clinical service and revenue cycle teams to improve charge capture and prevent avoidable denials.
• Remains up to date with the various Federal and Managed Care/commercial insurance companies’ correct claim submission regulation/policies. Provides support and guidance to co-workers on updates impacting workflows or processes.