Manager, Revenue Integrity

About Us

Our employees use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration

The Opportunity

Reporting to the Senior Manager, Revenue Integrity, the Manager, Revenue Integrity leads a high-profile group responsible for assuring complete and accurate charge capture across the enterprise, including the development of appropriate charge capture mechanisms. Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills combined with superb analytic and organizational abilities. The ability to meet deadlines while influencing but not directly managing the work of others is necessary.

Principal Duties and Responsibilities

* Manage a Revenue Integrity team.

* Initiate, coordinate, and implement all code and charge capture changes related to analyst assigned projects.

* Recruit, mentor and coach Revenue Integrity Analysts at various levels of development.

* Lead and participate in complex projects related to revenue cycle initiatives.

* Collaborate with Local Revenue Operations Departments, Local Budget Offices, Hospital Clinical Departments, Patient Accounting, Medical Records, Revenue Analysis, Compliance, Internal Audit, Pricing, and Revenue Control to integrate code and charge capture related functions and communicate changes to the chargemaster and coding and charging processes.

* Ensure that all charge documents and charge capture systems are updated to allow for accurate coding and charge capture.

* Communicate and coordinate training for coding and charge processing changes to clinical departments and local hospital management.

* Coordinate charge master maintenance and update process, including coding, charge assignment updates for hospital information systems, financial/operations impact analysis and review.

* Execute post implementation audits to ensure that chargemaster changes result in appropriate reimbursement. This includes verifying reimbursement and coordinating the review of medical records if needed to ensure that cost centers are processing charges appropriately.

* Perform quality audits related to analyst work product.

* Develop, maintain and implement department training materials.

* Develop, maintain and implement a Quality Audit Program and associated reporting.

* Work with Patient Accounting to ensure denials and billing errors related to the code and charge capture are addressed in a timely and accurate manner.

* Keep current on coding and chargemaster related issues through monitoring of the regulatory environment, review of literature, participation in professional organizations and continuing education.

* Execute on decisions made using sound judgment in dealing with compliance and regulatory issues.

* Develop and present recommendations for change. Obtain buy in from Administrative Directors and Physician Leaders.

* Manage special projects, implementations, and department initiatives as assigned.

Qualifications

* Five or more years of experience in a hospital setting or within the healthcare industry required

* Bachelor's degree required, master's degree preferred

* Strong computer and system experience related to multiple databases and computer logic

Skills and Abilities for Success

* Exceptional analytical background with ability to translate very technical information and findings to others

* Well developed, formal presentation skills

* Ability to present to and interact with senior levels of hospital management and with physician leaders

* Proven leadership skills, mentoring skills, and ability to motivate team members

* Excellent organizational and project management skills

* Strong time management, attention to detail, and follow through

* CPT and HCPCS coding experience required; coding certification preferred

* Excellent oral and written communication skills

* Exceptional communication and comprehension skills, including listening skills and ability to "read between the lines"

Supervisory Duties

* Direct reports; approximately 10 Revenue Integrity Analysts

* Demonstrates fiscal responsibility by effectively using Mass General Brigham resources

Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives, and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under the law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment.