Manager of Revenue Integrity & Coding

About the role

The Revenue Integrity & Coding Manager develops, manages and maintains processes and systems concerning current and compliant charge capture practices, chargemaster maintenance to federal and other regulatory requirements & HIPAA transaction sets, and modules and systems supporting all revenue cycle processes. They are responsible for drug administration and other charge capture for nursing services including Emergency Department services and for revenue cycle functions associated with reference and outpatient lab services to maintain minimal uncoded/unbilled accounts. They will collaborate and educate revenue-producing department managers & staff to maintain their Chargemaster effectiveness including revenue codes, CPT codes, modifiers and pricing. They will also collaborate and educate revenue-producing department managers & staff to improve their charge capture process and timeliness. They will manage nurse audit functions for Asante to respond to governmental & insurance audits, adverse events, Risk Management, and patient billing complaints.

Responsibilities

• Develop, manage, and maintain processes and systems concerning current and compliant charge capture practices.
• Maintain chargemaster to federal and other regulatory requirements & HIPAA transaction sets.
• Support modules and systems supporting all revenue cycle processes.
• Handle drug administration and other charge capture for nursing services, including Emergency Department services.
• Manage revenue cycle functions associated with reference and outpatient lab services to maintain minimal uncoded/unbilled accounts.
• Collaborate and educate revenue-producing department managers & staff to maintain Chargemaster effectiveness (revenue codes, CPT codes, modifiers, pricing).
• Collaborate and educate revenue-producing department managers & staff to improve charge capture process and timeliness.
• Manage nurse audit functions for Asante to respond to governmental & insurance audits, adverse events, Risk Management, and patient billing complaints.

Qualifications

• 5 years previous leadership or supervisory experience.
• 6 years progressive healthcare experience in medical records documentation with emphasis on coding and HCPCS coding rules and billing procedures.
• Previous charge master maintenance experience.
• Knowledgeable of governing regulations impacting all aspects of revenue cycle.
• Experience with MedSeries 400 databases; able to perform downloads and set up query reports.
• Knowledge of Optio, ImageNow, MIRA and patient accounting, Coding Resources.
• Bachelor's degree or equivalent required.
• Specialized education in medical terminology and coding systems including CPT4, HCPCS and ICD-9 required.
• Oregon Driver's License with proof of safe driving record for the past 10 years and proof of insurance required.
• Certified Coding Specialist (CCS) preferred.
• Licensed Practical Nurse (LPN) licensed by Oregon State Board of Nursing preferred.
• Registered Health Information Technician (RHIT) preferred.
• Registered Nurse (RN) licensed by Oregon State Board of Nursing preferred.