System Manager Revenue Integrity - CDI - Bronson Healthcare
Bronson, MI
About the Job
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Love Where You Work!
Team Bronson is compassionate, resilient and strong. We are driven by Positivity which inspires us to be our best and to go above and beyond for our patients, for one another, and for our community.
If you’re ready for a rewarding new career, join Team Bronson and be part of the experience.
Location
BHG Bronson Healthcare GroupTitle
System Manager Revenue Integrity - CDIProvides leadership and day-to-day operational management and direction for the Bronson Healthcare Group revenue integrity functions. Responsible for motivating staff to achieve the highest levels of performance, working in conjunction with all key stakeholders to prevent revenue leakage and maximize potential revenue for the system. Manages clinical documentation improvement. Charge Description Master (CDM), root cause analysis, denials coordination, including complex case denials, denial prevention, audits, and education and training of multi-disciplinary hospital teams. Manages revenue optimization opportunities which may include charge control processes. Responsible for optimizing staff and overall revenue performance through process redesign, policy/procedure implementation, communications, continuing education and professional development activities, staff empowerment and feedback.
QUALIFICATIONS
Three to five years of recent experience in revenue cycle, patient accounting, physician billing, or health information management, preferably in an academic setting.
- CCDS, CDIP or coding certification required. CPC preferred but will consider other coding certificates
- Epic PB Proficiency and Revenue Guardian certification preferred.
- Experience in Clinical Documentation Improvement (CDI) or oversight preferred.
- Experience in Charge Description Master (CDM) maintenance or oversight preferred.
EDUCATION AND/OR EXPERIENCE The minimum level of educational attainment and/or length and character of experience needed to perform the job effectively.
Bachelor's degree in Nursing, Business, Finance, Healthcare or related field required.
Minimum of three years of management experience in a multi-facility, integrated health care delivery system or revenue cycle/revenue integrity consulting.
Solid understanding of appeals, denials management, medical necessity, and coding.
Experience in Clinical Documentation Improvement (CDI) and Charge Description Manager (CDM) maintenance or oversight preferred.
Certification in professional services coding (required)
LICENSES, REGISTRATIONS, CERTIFICATIONS
Coding Certificate required. CPC preferred but will consider other coding certificates.
OTHER SKILLS AND ABILITIES
Excellent oral, written, organization, and interpersonal skills. Analytical skill necessary to assist in problem solving. Proven ability to exercise judgment and make appropriate decisions. Ability to learn and use computer systems competently and effectively.
WORK ENVIRONMENT
While performing the duties of this job, the employee regularly works in a clean, well lighted & temperature controlled environment. The noise level in the work environment is usually moderate.
PHYSICAL DEMANDS
While performing the duties of this job, the employee is occasionally required to stand. The employee is occasionally required to use hands to finger, handle, or feel. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision.
INTERPERSONAL REQUIREMENTS A brief paragraph that summarizes the communication responsibilities, including with whom, written/verbal, frequency, reporting relationship, etc.
Must be able to communicate verbally and in writing with management, physicians, nurses and colleagues. Daily and on-going communication with members of the revenue cycle.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Oversee all functions performed by the Revenue Integrity team, including analytics, reporting, communication with departments and external stakeholders and ongoing strategy and development of the program.
Manage the clinical documentation improvement (CDI) efforts throughout the system, create continuous learning initiatives for key providers and physician champions.
- Lead targeted revenue improvement opportunities and assist with analyzing the financial impact as related to clinical departments.
- Work proactively with Revenue Cycle leadership to prioritize areas of focus and ensure appropriate ongoing performance.
- Lead the establishment and implementation of Key Performance Indicators (“KPIs”) for revenue integrity functions.
- Develop, implement, and oversee effective and consistent operational policies, processes, tools and educational materials within all Revenue Integrity areas.
- Oversee the operational performance of a system-wide, service line-based Charge Review program to identify charge capture issues / improvement opportunities to minimize revenue leakage.
- Identify potential process improvements in charge capture.
- Build strong relationships and facilitate productive communication between key Revenue Cycle shareholders, including peer leaders of Revenue Cycle and core support departments.
- Ensure audit of denial management processes occurs consistently and coordinate with others to identify trends and implement denial prevention/recovery programs.
- Measure and report ongoing financial and operational performance of Revenue Integrity and denial management.
- Working knowledge of billing and collection processes and functions, charging processes and general revenue cycle management strategies, and industry best practices.
- Ability to effectively present information and respond to questions from groups of managers, clinicians, and department personnel.
- Excellent communication, leadership, delegation and interpersonal skills.
- Possess effective time management skills to permit handling of large workload.
- Denial Management & Avoidable Write-Off Prevention – utilize data analytics to identify trends and work with functional areas for future prevention.
Shift
First ShiftTime Type
Full timeScheduled Weekly Hours
40Cost Center
1225 Revenue Integrity (BHG)Agency Use Policy and Agency Submittal Disclaimer
Bronson Healthcare Group and its affiliates (“Bronson”) strictly prohibit the acceptance of unsolicited resumes from individual recruiters or third-party recruiting agencies ("Recruiters") in response to job postings or word of mouth. Unsolicited resumes sent to any employee of Bronson by Recruiters, without both a valid written agreement with Bronson and a direct written request from the Bronson Talent Acquisition Department for a specific job position, will be considered the property of Bronson. Furthermore, no fees will be owed or paid to Recruiters who submit resumes for unsolicited candidates, even if those candidates are hired. This policy applies regardless of whether the Recruiter has a pre-existing agreement with Bronson. Only candidates submitted through a specific written agreement with the Bronson Talent Acquisition Department for a named position are eligible for fee consideration.
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