Surgery Revenue Manager - Community Medical Centers of Fresno, CA

*All positions are located in Fresno/Clovis CA*

We got our start 125 years ago as a boarding house and medical facility for people traveling in Central California. If people then could see us now... Today, Community Health System is the region’s largest healthcare provider and includes three divisions: Community Medical Centers hospitals, Community Care Health and Community Provider Network. These three pillars of healthcare – hospitals, health insurance and physicians – work best when they work together.

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

We know that our ability to provide the highest level of care begins with taking care of our incredible teams. Want to learn more? Click here.

Perform complex financial, statistical, operational, and cost benefit analyses of charge capture projects for Surgical Services. Responsible for assisting in directing the operational, program development, and fiscal performance of the department. Provides leadership to ensure success in analyzing and monitoring the internal and external environment effecting the department, investigating and clarifying new opportunities and monitoring the use of resources and financial performance.

Accountabilities

• Manage the charge master for the entire Perioperative Services (Endoscopy, Short Stay, Post Anesthesia Care Unit, Cardiac Surgery, Perfusion and Surgery).
• Supervision and training of staff for Perioperative Services.
• Collaborate with Admitting Manager to ensure appropriate authorizations are obtained for patients prior to scheduled surgery.
• Perform annual reviews of data reporting systems to ensure report writing capabilities to senior management are available for statistical, financial and inventory purposes.
• Accountable for billing of research study projects, which consists of meeting with physicians to identify appropriate billing of services and supplies. Negotiates reimbursement rates for research study projects. Accountable for researching and identifying appropriate CPT and ICD-10 codes for research studies.
• Collaborate with Patient Financial Services to identify, correct and resolve documentation deficiencies.
• Collaborate with Information Systems and Decision Support to identify and create statistical and financial reports for senior management.
• Development, implementation and review all self pay patient processes for surgeons.
• Actively participate in the decision making processes of compliance, revenue cycle, coding and at times, may directly manage some or all of the activities in these areas or any other area deemed closely associated with the reimbursement function for Perioperative Services.
• Develop financial models, collects and evaluates data, makes appropriate assumptions, analyzes results and makes appropriate recommendations.
• Prepare analyses to evaluate department initiatives, participates in the development of the annual department strategic plan, physician marketing campaign in collaboration with department and leadership.
• Coordinate in-services to improve the general knowledge of sets, promote customer service and develop staff's ability to work as a team.
• Identify, research, prepare evaluations on a variety of complex and diverse projects/problems (financial, statistical, operational and cost/benefit analyses).
• Proactively identifies issues related to linkages with other departments, communicates and/or follows up accordingly.
• Monitor and analyze financial and budgetary performance, including explanation and justification of actual vs. budget variations as requested by management.
• Work to improve data quality, collection processes, report design to meet the diverse and changing needs for management reporting.
• Manage the charge master for Perioperative Services assuring compliance with all regulatory authorities requirements as required for claim submission and hospital reporting regulations.
• Facilitate the process of setting prices, establishing necessary codes for new charges associate with current and new programs insuring, the process is complete and in place in a timely manner.
• Directly responsible (with support from Human Resources) for employee engagement and people management processes including interviewing and selection, time and attendance approval, providing timely feedback and performance evaluations, employee development, employee retention, disciplinary actions and terminations.
• Performs other duties as assigned.

• Pay ranges listed are an estimate and subject to change.
• If any bonuses are noted, they are only applicable to external hires meeting criteria.