Description
Join Our Team at New Bridge Medical Center!**We are dedicated to providing high-quality, compassionate care to our diverse community. As a leading healthcare provider, we offer a supportive and inclusive work environment. If you’re passionate about making a difference and thrive in a collaborative setting, New Bridge Medical Center is looking for a Revenue Integrity Manager.
Job Duties
Analyze and resolve specific billing edits that require HCPCS/CPT coding based on the chargemaster expertise and that are delaying claims from processing in the Patient Accounting
Supports timely implementation of coding updates (CPT/HCPCS), periodic UB Revenue Code updates, modifier revisions and regulatory updates to CDM.
Serve as chargemaster liaison to facilitate clinical department education on appropriate charging of CPT codes, Revenue Codes, and communicating with Ancillary Departments to resolve issues.
Performs formal review of annual CPT/Diagnosis/HCPC changes and prepares educational documents by specialty highlighting significant changes.
Analyzes billing error and denial data to identify root causes.
Analyzes file data for evidence of deficiencies in controls, duplication of effort, or lack of compliance with laws, government regulations and policies and procedures Responsible for continuous maintenance and updating of the CDM including adding, changing and terminating charges.
Conducts audit and review day to day activities to improve billing and coding integrity for all BNBMC location.
Works with Information Technology and service departments to develop testing and monitoring strategies to support the implementation of new charge capture systems and methodologies.
Implements charge capture corrective measures and monitoring tools to ensure the sustainability of changes; performs, reviews, and monitors statistics and key performance indicators to identify improvement opportunities Establish and oversee the structure and processes to ensure timely/accurate charge capture and revenue monitoring policies and procedures are adhered to
Ensures deadlines and goals are met by completing assigned tasks and job duties timely, as well as escalate issues as necessary.
Increases productivity and accuracy by initiating automation processes and centralizing information requirements.
Finance projects and other duties as assigned.
Other DutiesPerforms other related duties as required.Position Qualifications:An overall understanding of Financial Management and Reporting in health care.An overall knowledge of the functions and activities of hospitals and medical clinics.Ability to participate with upper management in a decision support mode through the development of appropriate management information.Understanding of compliance issues and their importance and consequences.Knowledge and skill in using personal computers for electronic mail communications and Internet access along with internal intranet utilization.Knowledge of hospital financial computer systems, the A/R system and the Charge Master role within such systems.Demonstrates familiarity with computer programs used in the department.Speaks, reads and writes English to the extent required by the position.A strong understanding of the operations of the US healthcare system in the commercial, Medicare and Medicaid markets.Experience with healthcare clinical coding systems (CPT-4, HCPCS, ICD-10, NDC, MDC, DRG, etc.).Proficiency with data extraction and file manipulation using multiple data sources.Ability to document all aspects of his/her work and share knowledge with colleagues.Ability to define business problems, assess relevant variables and forces that impact the issue, and recognize relevant patterns in data.Ability to work independently with flexibility to new or varied responsibilities.Proven ability to manage multiple complex projects simultaneously.Demonstrates the highest degree of accuracy and readability for all work and team projects.Goal-oriented work ethic to meet short term and annual personal and department goals.Uses, protects, and discloses patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
EducationBachelor’s degree
Job Setting/Physical DemandsPatient accounts department office; contact with staff, patients and families, and third-party payors.Mainly sedentary with occasional reaching, stooping, bending, stretching.Manual dexterity.
We provide a comprehensive benefits package, including a competitive medical, dental, and vision plans. We prioritize work-life balance with a generous time off policy that includes ample vacation days, personal time, sick leave and nine paid holidays. Additionally, we are committed to the personal and professional growth of our employees, offering robust tuition reimbursement and continuing education programs to help support our employees ongoing development.
Qualifications
Education
Required
- Bachelors or better in Business Admin
Experience
Required
- 5-7 years: 5 - 7 years of hospital revenue cycle experience or healthcare data analytics experience