Operations Manager, Revenue Integrity (Full-Time, 40 Hours, Day Shift)

RESPONSIBILITIES

I. JOB SUMMARY/RESPONSIBILITIES:

• Supervises clinical and financial processes to improve revenue results, ensure integrity, and safeguard The Queen's Health Systems (QHS) medical facilities against exposure and penalties.

• Provides oversight of the charge capture processes across QHS to ensure that all valid charges are captured in the billing process in a timely and compliant manner.

• Identifies charge compliance issues and root causes of noncompliance. Ensures correction of issues and develops changes to workflow processes to ensure that issues are prevented in the future.

• Ensures operations and functions are in compliance with regulatory requirements and policies and procedures of QHS.

• Prepares and presents financial reports for executive management review.

II. TYPICAL PHYSICAL DEMANDS:

• Seeing, hearing, speaking, finger dexterity.

• Frequent: sitting.

• Infrequent: walking, stooping/bending, reaching at and below shoulder level.

III. TYPICAL WORKING CONDITIONS:

• Not substantially subjected to adverse environmental conditions.

IV. MINIMUM QUALIFICATIONS:

A. EDUCATION/CERTIFICATION AND LICENSURE:

• Bachelor's degree in Business Administration, Finance, Health Care Administration or related field; or four (4) years of progressive experience in revenue cycle or finance may be substituted for the educational requirement.

• Master's degree in a related field preferred.

B. EXPERIENCE:

• In addition to the educational requirement, four (4) years of experience in two (2) or more of the following revenue cycle areas: revenue integrity, charge capture, facility or professional coding, billing, compliance, or pricing and reimbursement, preferably in a comparable organization.

• One (1) year, supervisory/leadership experience.

• Experience to demonstrate the following:

o Working knowledge of charge master principles and the relationship to coding, billing and compliance in a hospital setting.

o Knowledge of contracts, financial analysis methods, accounting principles and health care delivery systems.

o Knowledge of requirements specific to government-funded health care program and third-party payer reimbursement.

o Proficiency with computer-based hospital billing/records applications and Microsoft Office applications, i.e. Word and Excel.

• Prior experience with Epic systems preferred.

Equal Opportunity Employer/Disability/Vet