• Supervisor - Revenue Integrity

    Posted: 12/26/2021

    Title:  Supervisor – Revenue Integrity
    FTE:  1.0 (40 hours per week)
    Schedule:  Monday-Friday from 8:00 am -5:00 pm
    Holiday Rotation: None
    Weekend Rotation:  None
    On Call Requirements:  None
    The Revenue Integrity Supervisor is responsible for oversight and leadership for a team that focuses on denials management, appropriate reimbursement maximization, charge capture, standard work processes, audit coordination, and documentation optimization for Sauk Prairie Healthcare.  

    Additionally, this role is responsible for leadership of clinical coding and Clinical Documentation Integrity (CDI) team to ensure compliance and appropriate facility reimbursement.  Facilitating ongoing education to the coding staff and well educating hospital personnel and providers on coding and clinical documentation requirements. 

    The Revenue Integrity Supervisor serves as the primary liaison for integration of revenue integrity throughout the organization, with a primary goal of enhancing patient net revenue and minimizing revenue leakage.

    Core Supervisor Responsibilities

    1. Routinely provides services at the staff level during periods of staffing instability and as needed to remain competent at staff level.
    2. Directly oversees and addresses daily operational needs, typically for a single cost center.
    3. Conducts daily rounds on team members to ensure optimal workflow and addresses daily staffing needs.
    4. Evaluates staff daily workloads to ensure equitable distribution of work and to determine appropriate staffing levels.
    5. Addresses staffing assignments on a daily basis, ensuring optimal workflows are implemented.
    6. Responsible for addressing human resource needs (e.g. interviewing, hiring, training and development, annual evaluations, etc.).
    7. Approves payroll for assigned team members.
    8. Under guidance of supervisor, coaches, counsels, and applies corrective action to employees as needed.
    9. Assists with development of policies, procedures, and productivity standards.
    10. Works directly with staff to maintain compliance with external regulations and internal policies
    11. Works directly with staff to maintain quality service by enforcing quality and customer service standards, analyzing and resolving quality and customer service problems, and recommending system improvements.
    12. Under the guidance of supervisor, sets goals for individual team members that are in alignment with the department’s and organization’s goals.
    13. Trains and onboards new hires to make sure they understand their roles. Communicates job expectations.
    14. Assists in budget development and monitors expenses as requested.
    15. Actively reviews staff use of materials, equipment, etc. and provides feedback to staff to ensure best use of resources.
    Position Specific Responsibilities
    1. Leads the activities of the CDI, and Coding Team to ensure accurate documentation, charging, and coding for for the clinical services and care provided to patients.
    2. Leads, directs, and audits coding staff to ensure ICD-CM, DRG, CPT, HCPCS codes and documentation accurately reflect the patient’s condition and the care delivered, within a timely fashion.
    3. Supervises and facilitates changes to the Charge Description Master as needed for new services and/or identified missed revenue opportunities.  This includes quarterly and annual updates relative to CPT/HCPCS code changes.
    4. Monitors charge capture and reconciliation workflows to ensure that revenue is captured for all services provided.
    5. Develops and maintains collaborative working relationships with revenue producing departments, information systems personnel, finance, HIM, compliance, and revenue cycle team members.
    6. Provides direction and leadership on denial management, including consultation and review of challenging cases.  This includes clinical denials and appeals, such as medical necessity, RAC and charge audits
    7. Identifies and communicates external developments affecting the revenue integrity process, such as regulatory changes, contractual modifications, and payor policy changes.  Assists with implementation of any needed workflow changes.
    8. Monitors and documents payor denial and/or underpayment trends and changes to payor’s medical policies.  Informs appropriate departments of these changes and works to implement needed change on these workflows.  Reports monthly on charge capture and denial activity, to demonstrate program performance and/or gains to organization relative to proposed workflow changes.
    9. Monitors staff and vendor productivity to prevent delays in claims or appeal submission.
    10. Develops relationships with assigned vendors to ensure contract performance metrics are met.
    11. Assists with resolution of patient complaints related to billing.
    12. Facilitates regular staff meetings.
    13. Other duties as assigned.

    • Required:  Associates degree in Healthcare related field
    • Preferred: Bachelor’s degree
    • Required:  3-5 years of coding experience
    • Preferred:  5+ years coding experience and prior healthcare leadership experience
    Licenses and Registrations
    • Required:  None
    • Preferred:  None
    • Required:  Coding credentials through the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) in any of the following certifications:?
      • Registered Health Information Technician (RHIT)
      • Certified Coding Specialist (CCS)
      • Certified Procedural Coder – Hospital (CPC-H)
      • Certified Procedural Coder (CPC)
      • Certified Inpatient Coder (CIC)
      • Certified Outpatient Coder (COC)
    • Preferred:  None
    1. Competitive health and dental insurance options
    2. Flexible paid time off to balance work and life
    3. Retirement plan with immediate vesting and employer match
    4. Free membership to our state-of-the-art fitness facility
    5. Generous tuition reimbursement
    6. Employer provided life and disability insurance
    7. Free parking at facility
    Interested in an extraordinary career? Click the link to apply.