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POSITION SUMMARY

Reporting to the SENTA CFO,  the Revenue Integrity Manager is responsible for providing leadership in developing, planning, organizing, directing, and managing the activities of the revenue integrity team, as well as providing leadership related to charge capture, Charge Description Master (CDM) management and development, documentation, and coding quality across the enterprise. This role provides strategic oversight for all assigned revenue integrity projects. Functions include, but are not limited to, partnering with revenue cycle leaders and staff on process-based projects, cross-functional collaboration impacting revenue cycle performance and operations. The role is also responsible for analyzing data provided by the revenue integrity team to drive efficient standardized workflows. In addition, the role will be responsible for establishing and maintaining policies and procedures related to CDM maintenance and development, charge capture, and coding and will serve as a liaison with department managers and vendors.

 

MAJOR DUTIES AND RESPONSIBILITIES:

  • Leads the revenue integrity department, overseeing charge capture, coding, and documentation improvement.
  • Develops and maintains charge reconciliation and capture policies, including CDM maintenance and training materials.
  • Communicates payer regulations to clinical departments, providers, and vendors.
  • Distributes coding and billing updates to relevant stakeholders.
  • Collaborates for process improvements in billing and reimbursement with vendors and revenue cycle departments.
  • Assesses revenue cycle project requests, evaluating impact and presenting findings and recommendations to leadership.
  • Conducts reimbursement analyses, reviews trends, and provides education on billing/coding guidelines and denials.
  • Manages CDM maintenance and development, ensuring accurate coding and service updates.
  • Understands and improves revenue cycle operations, coordinating with vendors and staff for system enhancements.
  • Undertakes additional responsibilities as needed.

 

EDUCATION AND EXPERIENCE

 Bachelor’s Degree and 4 years of relevant experience; or equivalent combination of education and/or experience.

  • Certified Professional Coder through American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA).
  • Minimum of 5 years’ experience in revenue cycle management, reimbursement, physician documentation, coding and billing, including 2 to 3 years' management experience.
  • Advanced skill with Microsoft applications including Outlook, Word, Excel, PowerPoint, Access and other web-based applications.

 

PREFERRED QUALIFICATIONS

  • Experience building reports, interpreting data, and developing recommendations for process improvement.
  • Strong working knowledge of professional billing software application(s) and clinical application(s).
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