Revenue Integrity Manager

JOB REQUIREMENTS: Revenue Integrity Manager Come work where we

specialize in you! We have nearly 2,000 reasons for you to consider a

career with Prevea Health-they\'re our employees. We\'re an organization

that values kindness, responsibility, inclusivity, wellness and

inspiration. At Prevea, we provide continuous education, training and

support so every member of the team contributes to our success. Together

we are the best place to get care and the best place to give care. Job

Summary The Revenue Integrity Manager will lead the development of the

revenue integrity function and is responsible for the oversight and

management of the revenue integrity team. This position is accountable

for optimizing revenue by ensuring accurate, compliant, and efficient

charge capture and billing practice. The Revenue Integrity Manager will

improve the performance of revenue cycle processes including developing

best practices, coordinating issue resolution, establishing proactive

lost revenue prevention measures, and monitoring compliance. The ideal

candidate has a strong understanding of EPIC systems, coding standards,

and billing regulations across both physician and facility revenue

streams. What you will do \* Utilize data analytics and process

improvement techniques to identify potential revenue leakage and support

accurate charge capture. Use EPIC reporting tools to extract and analyze

charge data. Perform extensive data mining, develop reports, review

trends, and recommend enhancements to resolve lost revenue. \* Manage a

team of chart reviewers. Design and implement a chart review program to

ensure completeness of records, appropriateness of billing, and

compliance with regulatory and payer requirements. \* Identify coding

and documentation discrepancies to provide recommendations. Monitor for

positive or negative trends in coding, charge capture and/or editing

processes. Analyze denial trends related to charge capture and billing.

Collaborate with coding, billing, and clinical teams to identify root

causes and implement corrective actions. \* Maintain documentation of

audit findings, trends, and resolutions to support compliance and

training efforts. Measure key performance indicators (KPIs). Prepare

reports and present findings and recommendations to management. \*

Oversee and maintain the CDM, identifying opportunities for missed

revenue. Including an annual comparison of Prevea\'s CDM and

supply/implant costs to payer contracts. Develop and maintain all retail

pricing. Participate in service line pricing reviews. \* Research and

stay current on CMS, federal and state regulations, payor guidelines,

ensuring compliance and alignment with charge, coding and charge edits.

Complete analysis of revenue impacts as a result of CMS payment changes.

\* Performs full range of managerial responsibilities which may include

but not be limited to\... For full info follow application link. Prevea

is an Equal Employment Opportunity/Affirmative Action employer

\*\*\*\*\* APPLICATION INSTRUCTIONS: Apply Online:

ipc.us/t/9CB695E6AA8A43B1