Team Lead - Revenue Integrity - Summa Western Reserve Hospital : Job Details

Team Lead, Revenue Integrity

Full-Time Days - Revenue Cycle Billing Operations

Summa's Corporate Office

Summa Health System is recognized as one of the region's top employers by a number of third party organizations, including NorthCoast 99. Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and competitive pay and benefits.

Summary:

Provides leadership and oversight to the Revenue Integrity team, the Charge Description Master (CDM), and acts as a resource for clinical charging departments. Provides support and insight into Revenue Cycle processes including front-end avoidable denials, charge capture/ reconciliation, report trending and analytics, training/education as needed. Provides the overall timely and accurate capture of patient service revenue, oversight in the development, implementation, maintenance, improvements, and audit functions of Summa's Charge Description Master (CDM). Serves as liaison, monitors and communicates current regulations and reporting requirements as set by government or other payers, and ensures any changes are properly implemented through project oversight. As lead, partners with Executive leadership throughout the organization in support of Revenue Integrity.

Formal Education Required:

a. Bachelor's degree in Business Administration, Health Services, Finance or closely related field, or the equivalent in training and experience.

b. Master's degree in Business Administration, Health Services, Finance, or closely related field - preferred.

c. Required Licenses/Certifications: Certification as a medical coder through AHIMA (CCS, CCS P) or through AAPC (CPC-H) and/or certification as a Revenue Cycle Integrity Professional (CRIP).

Experience & Training Required:

a. Three (3) years related professional/business experience in a technical/financial healthcare environment to include demonstrated experience in utilization of Epic that has provided leadership skills.

Other Skills, Competencies and Qualifications:

a. Knowledgeable of charging and billing best practices.

b. Solid computer technical skills required, including proficiency with Microsoft Office products (Word, Excel, Access, and PowerPoint).

c. Proven excellent communication and customer service skills, including the ability to progressively investigate, analyze and identify sources of problems, provide practical solutions, and negotiate resolutions.

d. Ability to make independent business decisions, considering both the impact on client satisfaction and overall fiscal impact for the department and organization.

e. Ability to streamline processes for efficiency. Strong analytical aptitude and experience creating financial analysis. Possesses a good sense of general business acumen.

f. Strong understanding of DRG and CPT/HCPC Medical Coding and Medical Terminology.

g. Basic understanding of Accounting Principles and Hospital Financial Reporting.

Level of Physical Demands:

a. Sedentary: Exerts up to ten pounds of force occasionally and/or a negligible amount of force frequently.

Equal Opportunity Employer/Veterans/Disabled

$30.60/hr - $45.90/hr

The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.