Adventist Health
Multi-Site Manager, Revenue Integrity
Adventist Health, Roseville, California, United States, 95678
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Multi-Site Manager, Revenue Integrity
role at
Adventist Health .
Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. The campus was unveiled in 2019 as WELL-certified, a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams enjoy a welcoming space designed to promote well-being and inspire best work.
Job Summary Oversees the daily revenue integrity functions that support accurate charging and billing in compliance with state and federal regulations at the facilities within an Adventist Health system. Supports the implementation of system-wide standardization and facilitates long-term strategies to meet expanding and changing needs, in collaboration with operational and clinical leadership. Provides expert advice on charging/reimbursement aspects of growth initiatives. Assists in setting hospital and professional pricing strategies to include maintenance and develops and implements policies for the operations. Leverages automation for the technical charge description master (CDM) build within Cerner. Assures compliance, manages staff, supports department communication and education for charge capture related matters.
Job Requirements
Education and Work Experience: Bachelor’s Degree or equivalent combination of education/experience: Required
Master’s Degree: Preferred
Five years' healthcare revenue cycle experience: Preferred
Application/technical work experience: Preferred
One year leadership experience: Preferred
Licenses/Certifications
Certification in Current Procedural Terminology (CPT) coding: Preferred
Essential Functions
Supports the creation and implementation of policies for operations, programs, and all activities to achieve a compliant, standard charge master across the health system and/or market, as applicable. Ensures that processes and data meet standards established by the regulatory bodies and Adventist Health executive leadership. Leads team of revenue integrity specialists, CDM coordinators, charge capture associates, charge assurance nurse auditors, and reporting and data analysts across the system and/or market, as applicable. Drives continuous improvement in revenue integrity and chargemaster activities including the identification and implementation of applications and/or vendor partnerships which enhance operational performance. Supports annual review of the CDM. Manages ongoing maintenance to ensure a compliant and complete chargemaster for professional and facility charges.
Leverages automation through electronic health record (EHR) and technology to streamline processes and maximize the effectiveness of the department. Ensures support to revenue cycle for change related denials and CDM adaptation for payer specific requirements. Supports all pricing strategies and pricing policies for Adventist Health, and ensures team follows established pricing guidelines. Manages tasks within the department to ensure charge codes and charge capture processes exist for all patient services, medications, and supplies. Requires strong communication and influencing skills with clinical leaders and IT staff to guide work performed in other areas of the organization. Compiles complex financial analysis to understand gross and net revenue implications of charging decisions and/or assess compliance issues.
Reviews, monitors, and analyzes revenue performance and status on a regular basis to identify trends and strategize for continuous improvement and course correction. Supports strategic audits to identify opportunities to streamline charge capture processes and increase net revenue. Supports team on validating integrity of charges with ability to provide corrective action plans to remediate where necessary. Serves as the system and/or market’s leading authority regarding reimbursement issues. Communicates status and potential issues to revenue integrity leadership and supports related organizational preparation initiatives including process and system changes, communication, education, and training. Provides training and education to clinical, clerical, and professional staff regarding accurate and appropriate charge capture and reconciliation. Ensures consistency in education, timely regulatory updates, and proper documentation standards and adherence to compliance initiatives. Monitors all areas for appropriate revenue capture via multiple layers of analytical tools and reports.
Manages department communication and education of charge capture related workflows, including identified changes in processes, structures, or systems/functionality. Serves as a resource to system and/or market staff at all levels for questions regarding charging processes and resulting gross revenue. Supports development and manages distributions of system-wide charge capture compliance operational key performance indicators, to include establishing benchmarks and targets consistent with industry standards and best practices to track and trend performance and results. Ensures all federal and state regulatory requirements are met. Leads implementation of long-term strategies to meet the expanding and changing needs of the system and/or markets. Manages the timely preparation of all reports, assigning projects, maintaining completion schedules, and following up as appropriate.
Documents results of all special project work and provides recommendations for revenue managing opportunities related to special projects. Demonstrates ability to effectively manage multiple projects. Develops effective relationships among internal/external stakeholders, colleagues, and staff in order to build trust and lead individuals/teams through change initiatives. Regularly communicates with clinical leaders, revenue cycle staff, IT, finance, managed care, and leadership. Performs management functions within the provisions of Adventist Health policies and standards and federal, state, and local regulations. Provides guidance, oversight, and adherence monitoring of CDM and revenue integrity-related departmental policies and procedures. Acts as subject matter expert in clinical and coding fields through journals, seminars, and other materials as applicable. Maintains current knowledge of ICD-10 and CPT coding regulations.
Performs other job-related duties as assigned.
Organizational Requirements Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
About Us Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Accounting/Auditing and Finance
Hospitals and Health Care
#J-18808-Ljbffr
Multi-Site Manager, Revenue Integrity
role at
Adventist Health .
Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. The campus was unveiled in 2019 as WELL-certified, a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams enjoy a welcoming space designed to promote well-being and inspire best work.
Job Summary Oversees the daily revenue integrity functions that support accurate charging and billing in compliance with state and federal regulations at the facilities within an Adventist Health system. Supports the implementation of system-wide standardization and facilitates long-term strategies to meet expanding and changing needs, in collaboration with operational and clinical leadership. Provides expert advice on charging/reimbursement aspects of growth initiatives. Assists in setting hospital and professional pricing strategies to include maintenance and develops and implements policies for the operations. Leverages automation for the technical charge description master (CDM) build within Cerner. Assures compliance, manages staff, supports department communication and education for charge capture related matters.
Job Requirements
Education and Work Experience: Bachelor’s Degree or equivalent combination of education/experience: Required
Master’s Degree: Preferred
Five years' healthcare revenue cycle experience: Preferred
Application/technical work experience: Preferred
One year leadership experience: Preferred
Licenses/Certifications
Certification in Current Procedural Terminology (CPT) coding: Preferred
Essential Functions
Supports the creation and implementation of policies for operations, programs, and all activities to achieve a compliant, standard charge master across the health system and/or market, as applicable. Ensures that processes and data meet standards established by the regulatory bodies and Adventist Health executive leadership. Leads team of revenue integrity specialists, CDM coordinators, charge capture associates, charge assurance nurse auditors, and reporting and data analysts across the system and/or market, as applicable. Drives continuous improvement in revenue integrity and chargemaster activities including the identification and implementation of applications and/or vendor partnerships which enhance operational performance. Supports annual review of the CDM. Manages ongoing maintenance to ensure a compliant and complete chargemaster for professional and facility charges.
Leverages automation through electronic health record (EHR) and technology to streamline processes and maximize the effectiveness of the department. Ensures support to revenue cycle for change related denials and CDM adaptation for payer specific requirements. Supports all pricing strategies and pricing policies for Adventist Health, and ensures team follows established pricing guidelines. Manages tasks within the department to ensure charge codes and charge capture processes exist for all patient services, medications, and supplies. Requires strong communication and influencing skills with clinical leaders and IT staff to guide work performed in other areas of the organization. Compiles complex financial analysis to understand gross and net revenue implications of charging decisions and/or assess compliance issues.
Reviews, monitors, and analyzes revenue performance and status on a regular basis to identify trends and strategize for continuous improvement and course correction. Supports strategic audits to identify opportunities to streamline charge capture processes and increase net revenue. Supports team on validating integrity of charges with ability to provide corrective action plans to remediate where necessary. Serves as the system and/or market’s leading authority regarding reimbursement issues. Communicates status and potential issues to revenue integrity leadership and supports related organizational preparation initiatives including process and system changes, communication, education, and training. Provides training and education to clinical, clerical, and professional staff regarding accurate and appropriate charge capture and reconciliation. Ensures consistency in education, timely regulatory updates, and proper documentation standards and adherence to compliance initiatives. Monitors all areas for appropriate revenue capture via multiple layers of analytical tools and reports.
Manages department communication and education of charge capture related workflows, including identified changes in processes, structures, or systems/functionality. Serves as a resource to system and/or market staff at all levels for questions regarding charging processes and resulting gross revenue. Supports development and manages distributions of system-wide charge capture compliance operational key performance indicators, to include establishing benchmarks and targets consistent with industry standards and best practices to track and trend performance and results. Ensures all federal and state regulatory requirements are met. Leads implementation of long-term strategies to meet the expanding and changing needs of the system and/or markets. Manages the timely preparation of all reports, assigning projects, maintaining completion schedules, and following up as appropriate.
Documents results of all special project work and provides recommendations for revenue managing opportunities related to special projects. Demonstrates ability to effectively manage multiple projects. Develops effective relationships among internal/external stakeholders, colleagues, and staff in order to build trust and lead individuals/teams through change initiatives. Regularly communicates with clinical leaders, revenue cycle staff, IT, finance, managed care, and leadership. Performs management functions within the provisions of Adventist Health policies and standards and federal, state, and local regulations. Provides guidance, oversight, and adherence monitoring of CDM and revenue integrity-related departmental policies and procedures. Acts as subject matter expert in clinical and coding fields through journals, seminars, and other materials as applicable. Maintains current knowledge of ICD-10 and CPT coding regulations.
Performs other job-related duties as assigned.
Organizational Requirements Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
About Us Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Accounting/Auditing and Finance
Hospitals and Health Care
#J-18808-Ljbffr