ChristianaCare is searching for a Revenue Integrity Team Lead to join our Medical Audit team and will manage, coordinate, and implementing complete, correct, timely and compliant charge capture initiatives and processes. This position will handle reviewing and interpreting Managed Care contracts, and Government fee schedules and regulations to ensure appropriate reimbursement.
When you become an employee at ChristianaCare, you are joining a healthcare organization that was named Forbes 5th Best Health System to Work for in the U.S. for 2021! Guided by excellence and love, our Caregivers enjoy many employee benefits such as
Conducts root-cause analyses with Revenue Integrity Analysts to identify opportunities for error reduction.
Conducts audits and reviews activities to improve the revenue cycle, claims production and coding integrity. Reviews data and systems to target areas of improvement.
Serves as a subject matter expert and in a consultative role to various levels of customers; works closely and collaboratively with Clinical Department Leaders.
Maintains knowledge of and organizational compliance with state, federal, and other third-party payer billing and reimbursement guidelines.
Responsibilities include all aspects of Revenue Cycle support including performance improvement, development, documentation, testing, training and upgrades. Assist management in examining processes to improve workflow.
Reviews, monitors, and facilitates implementation of billing and coding changes affecting charge capture processes in accordance with payer requirements.
Provides guidance and education to billing and clinical department staff related to appropriate
documentation requirements, denials resolution, and regulatory requirements relevant to charging, coding and billing.
Compiles and analyzes data from various sources to develop recommendations leading to potential revenue cycle opportunities, including analyses related to CDM set-up, charge capture, billing and/or patient financial services.
Conducts and leads special projects to facilitate revenue management as required for new facilities/acquisitions, new departments, new service lines, changes in regulations, etc.
Implements charge capture corrective measures and monitoring tools to ensure sustainability of changes; performs, reviews, and monitors statistics and key performance indicators to identify improvement opportunities.
Maintain current knowledge in present areas of responsibility (i.e., self-education, attends ongoing educational programs).
Develop and maintain tracking reports.
Articulate thoughts and ideas effectively both verbally and in writing.
Present information effectively in a variety of settings: one-on-one, small and large groups, with peers, direct reports, and superiors.
Document all procedures and activities timely, accurately, and legibly.
Demonstrates the highest level of confidentiality and conducts self according to AHIMA Code of Ethics.
EDUCATION AND EXPERIENCE REQUIREMENTS:
Bachelor's degree from an accredited college in a relevant field of study.
Equivalent and relevant combination of education and experience may be considered in lieu of Bachelor's degree.
Five years of revenue cycle management and/or revenue integrity experience in a healthcare environment.
Internal Number: JR56617
About ChristianaCare Health System
ChristianaCare Health System is headquartered in Wilmington, Delaware and is one of the country's largest health care providers, ranking 21st in the nation for hospital admissions. Christiana Care is proudly a Nurse Magnet recognized institution. Christiana Care Health System is also one of the largest health care providers in the mid-Atlantic region, serving all of Delaware and portions of seven counties bordering the state in Pennsylvania, Maryland and New Jersey. A not-for-profit, non-sectarian health system, Christiana Care includes two hospitals with more than 1,100 patient beds, and is a major teaching hospital with two campuses. Christiana Care is continually recognized for excellence on a regional and national level. Our role in the community is expressed in the Christiana Care Way: "We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value."Christiana Care is a great place to work because we value diversity and recognize it to be a core part of our success. Because of the diversity of our employees, affiliated health professionals and volunteers, we are ...positioned to meet the unique needs of our patients and community. We acknowledge and celebrate the uniqueness and talent of each employee. Because of our talented workforce we are able to provide a quality healthcare experience to our patients and community. We strive to create an inclusive environment in which individual diversity can be leveraged and thrive. Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.