收入合规分析师经理
Revenue Integrity Analyst Manager
公司简介
Shriners Children’s 是一个尊重、支持并重视彼此的组织。被《福布斯》评为2025年最佳中型企业雇主，我们致力于提供卓越的患者护理，拥抱具有全球影响力的多学科教育和研究。我们营造了一个重视循证实践、经验、创新和批判性思维的学习环境。我们的同理心、诚信、责任感和韧性定义了我们在儿童专科护理领域的领导地位，为孩子们及其家庭服务。
我们在全球拥有20多家医院、门诊诊所、日间护理中心和外展地点，无论家庭是否有支付能力或保险状况，我们都为18岁以下的儿童提供优质的护理。请点击此处了解我们的更多地点信息。
现任员工：请登录 Workday 点击此处通过“职位中心”内部申请
职位描述
收入完整性经理负责管理并协调 SC 组织内所有收入完整性费用捕获活动。这包括制定必要的流程和程序，以确保所有可收费程序的准确及时捕获，并监督所有费用对账流程。还需与关键利益相关者保持沟通，就费用捕获流程的更新进行交流，以确保 SC 内部持续保持费用捕获的准确性并得到遵守。通过定期审查 SC 内的所有可收费服务和活动，进行流程合规性监督，并向 SC 高级管理层、业务线负责人和同事提供关于流程改进和收入提升机会的反馈和培训。
主要职责：
- 负责收入周期支持的所有方面，包括绩效改进、文档、开发、测试、培训、升级，并协助管理层和高级领导审视流程以优化工作流。
- 汇总并分析数据，提出建议，以发现潜在的收入周期机会，包括与 CDM 设置、费用捕获和计费相关的分析。
- 为审计发现、建议和/或更正提供分析、趋势报告和充分支持的文档，根据最佳实践、合规性和 SC 政策对个别医院流程进行调整。
- 保持对州、联邦法规的组织合规性的了解，
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Company Overview
Shriners Children’s is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families.
With 20+ hospitals, outpatient clinics, ambulatory care centers and outreach locations across the globe, we provide excellent care to children up to age 18 regardless of their family’s ability to pay or insurance status. Please click here to learn more about our locations.
CURRENT EMPLOYEES: Please log into Workday Click Here to apply internally through the "Jobs Hub"
Job Description
The Revenue Integrity Manager is responsible for management and coordination of all Revenue Integrity charge capture activities throughout the SC organization. This includes the development of processes and procedures necessary to ensure accurate and timely capture of all chargeable procedures and oversight of all charge reconciliation processes. Also responsible for maintaining communication with key stakeholders regarding updates to charge capture processes to ensure charge capture accuracy is maintained and adhered to throughout SC. Performs oversight of process adherence through regular reviews of chargeable services and activities throughout SC and provides feedback and education to SC Senior Leadership, Service Line Leaders and colleagues on process improvements and areas of opportunity for revenue enhancement.
Key Responsibilities:
- Responsibilities include all aspects of Revenue Cycle support including performance improvement, documentation, development, testing, training, upgrades, and assist management and senior leadership in examining processes to improve workflow.
- Compiles and analyzes data to develop recommendations leading to potential revenue cycle opportunities, include analyses related to CDM set-up, charge capture, and billing.
- Provides analysis, trended reports and well supported documentation for audit findings, recommendations and/or corrections to individual hospital processes according to best practice, compliance and SC policy.
- Maintains knowledge of an organizational compliance with state, federal, and other third-party payer billing and reimbursement guidelines.
- Conducts charge capture assessment activities including interviews, research, and outcomes analysis. Provides analysis, well-supported documentation and recommendations for changes, additions and/or corrections to the CDM according to best practice and company standards.
- Provides support, communication and education to multiple facilities and corporate staff on correct charge capture, billing and coding processes, and state and federal guidelines.
- Assists in identifying, defining, and functioning within current software processes (i.e., Craneware, EPIC); review and/or development of reports and audit tools to support the requirements for revenue integrity and outcomes measurement.
- Performs audits with a focus on revenue cycle integrity, assists in the development and implementation of charge practices and conducts root-cause analyses with Revenue Integrity Analysts to identify opportunities for error reduction.
- Tracks and monitors key revenue cycle performance indicators; reports key findings to appropriate leadership and stakeholders across the organization.
- Manage the performance and productivity of the team as it relates to CDM maintenance and charge capture processes.
- Consistently complete performance monitoring processes and implement corrective actions as required.
- Ensure revenue integrity and clinical department staff comply with established Revenue Integrity/Revenue Cycle policies, processes and quality assurance programs.
- Support rollout of process improvements through the charge capture functions.
- Maintain up-to-date knowledge of regulatory and compliance changes impact the CDM, charging requirements and operations and ensure revenue integrity and charge champion and service line leaders are appropriately educated and the CDM charging tools and processes are modified as need to capture revenue for services rendered.
- Proactively works with department leaders to provide education as it pertains to changes in charge capture in accordance with local/nation and payor guidelines.
- Effectively and professionally communicates results, challenges and solutions through daily interaction, regular reports, and monthly status meetings with Corporate Director of Revenue Integrity/Denials Management and/or Executive Director of Revenue Cycle.
- Completes special projects, as directed by the Corporate Director of Revenue Integrity/Denials Management and/or Executive Director of Revenue Cycle; provide other support as needed.
- Leads the Revenue Analyst team by providing feedback, constructive critique of work and job performance, and plans and organizes the functions and activities of the team to ensure department and corporate goals are met.
- Develops and maintains effective relationships and communications with leaders, technical/application teams and external customers.
- Responsible for Epic Resolute HB/PB and Resolute HB/PB Claims, as well as other related billing applications.
- Prepare and execute functional system and program specifications using structured methodology.
- Serve as a subject matter expert on assigned project teams and department initiatives, develop test scripts, conduct testing, support application upgrades and project go lives.
- Utilize advanced application & analytic skills to design, build and test solutions to meet the needs of the organization.
Required Qualifications:
- Bachelor’s degree in business/accounting/finance or healthcare/business administration
- 10 or more years of hospital/clinic-based revenue cycle experience focused on revenue integrity and compliance.
- 5 or more years of hospital-based billing, coding, and charge capture experience. Proficient knowledge of charge master components) CPT codes, HCPCs, Revenue Codes, GL and cost Centers.
- Charge capture, billing, or coding experience to include pharmacy, radiology, surgery/anesthesia, outpatient clinic, and inpatient hospitalization.
- Five or more years of Epic PB and HB experience
- Partner with Patient Financial Services, Finance, Compliance, Information Services, and other departments on revenue management initiatives and strategic planning.
Preferred Qualifications:
- Master’s degree
- Applicable clinical or professional certifications and licenses desirable.
- HFMA, AAPC, CPC, CRCT
- Epic HB/PB certification
Compensation is determined based on years of relevant experience and departmental equity.Originally posted on Himalayas