Summary: The Manager of Revenue Integrity leads and provides operational and technical direction to the Revenue Integrity teams and Patient Financial Services (PFS). Responsibilities include: Oversight on activities related to Charge Capture, Denials and Revenue Reconciliation process including problem accounts and Work Queues. Develop financial models to support strategic analyses and decision making; Create documentation to support training and assist in troubleshooting system problems; Oversee the use of appropriate tools to identify revenue leakage, maximize reimbursement opportunities, accelerate cash flow opportunities, and ensure that all revenue is captured; Serve as a technical leader and has overall responsibility for providing in-depth expertise with implementation of new revenue related systems, system conversions, and system integration; Working in conjunction with finance and clinical departments, the Revenue Integrity Manager; Seeks to continually improve billing processes and ensure accurate and optimal revenue capture and utilization of standardized workflows; and participates in hiring and mentoring staff to support those functions. Develop best practices for reporting and other analytics to identify opportunities or problems, process improvements, and other system changes; Assist as needed in ongoing review and process audits including compliance with third party and Government payors, proper coding, billing and denials. Work closely with Compliance Office and provides expertise to leadership and analysts in developing on-going analytic tools including ad-hoc queries and reports for members of the Revenue Cycle and Finance teams.
High school diploma or equivalent required. Bachelor's degree in Health Care Administration, Business, Accounting, Finance or related field preferred.
Five years hospital revenue cycle or financial analysis experience required.
Three years' experience in leadership role preferred.
Ability to apply appropriate supervisory, management, and leadership techniques in an operational setting.
Excellent ability to understand and interpret statistical reports and perform quantitative analysis.
Knowledge of the principles of Information Systems in order to effectively analyze and make decisions. Ability to read, understand and interpret, analyze, and apply complex regulatory requirements.
Knowledge of healthcare related financial and/or accounting practice.
Skill in problem-solving in a variety of settings and translation of data into actionable steps.
Ability to deal effectively with constant changes and be a change agent.
Detailed knowledge of diversified insurance plans and reimbursement methodologies and claim processing.
Knowledge of state, federal and compliance regulations as they pertain to charging, coding, and billing processes and procedures.
Prior experience with Epic Systems Revenue Cycle Solutions preferred.
Internal Number: 47572
About Cook Children's Health Care System
Cook Children's Health Care System is a not-for-profit, nationally recognized pediatric health care organization comprised of eight entities – a Medical Center, Physician Network, Home Health company, Northeast Hospital, Pediatric Surgery Center, Health Plan, Health Services Inc., and Health Foundation.Cook Children's Medical Center Based in Fort Worth, Texas, the integrated system has more than 60 primary and specialty care offices throughout North Texas. Its service region includes Denton, Hood, Johnson, Parker, Tarrant and Wise counties, with an additional referral area encompassing nearly half the state.Cook Children's traces its roots back to 1918, but throughout its continual change and robust growth, it still embraces an inspiring promise – to improve the health of every child in its region through the prevention and treatment of illness, disease and injury. To live up to this promise, Cook Children's combines the art of caring with the use of leading technology and extraordinary collaboration to provide exceptional care for every child, every day.History – Cook Children's has a rich history of nearly a century of caring for children.Our Promise – Knowing that every child's ...life is sacred, it is the promise of Cook Children's to improve the health of every child in our region through the prevention and treatment of illness, disease and injury.Companies – Based in Fort Worth, Texas, Cook Children's is a not-for-profit organization that is comprised of eight nationally recognized companies.Community Health Outreach – Cook Children's Community Health Outreach works together with over 150 partner organizations to improve the safety and health of at-risk children through education, disease and injury prevention and support.Clinical Research – Cook Children's is home to a skilled team of research-minded physicians, nurses and health care professionals and administrators who drive our commitment to excellent clinical care and the search for medical advances.Public Relations – Cook Children's Public Relations works with national and local media outlets, produces Cook Children's publications, coordinates special events and helps develop key relationships within the community.Contractor & Vendor Information – Cook Children's contractors and vendors must ensure their employees are knowledgeable about working with our organization.Sponsorship guidelines – Cook Children's sponsors a select number of events that are strongly aligned with its promise to improve the health of every child in the region through the prevention and treatment of illness, disease and injury.