Manager, Revenue Integrity at UT Southwestern Medical Center

%3Cp%3E%3Cstrong%3EWHY UT SOUTHWESTERN?%3C/strong%3E%3Cbr%3EWith over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to %3Ca target=%22_blank%22 rel=%22noopener noreferrer%22 href=%22https://www.utsouthwestern.edu/newsroom/articles/year-2022/july-us-news-best-hospital.html%22%3EU.S. News %26amp; World Report%3C/a%3E, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you%27ll discover a culture of teamwork, professionalism, and a rewarding career!%26nbsp;%3Cbr%3E%3Cbr%3E%3Cstrong%3EJOB SUMMARY%3C/strong%3E%3Cbr%3E%3Cstrong%3EUT Southwestern has a new employment opportunity available for a Manager, Revenue Integrity within the Decision Support Department. The successful candidate in these duties will include but will not be limited to the following:%3Co:p%3E%3C/o:p%3E%3C/strong%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Co:p%3E %3C/o:p%3E%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EMust be a Registered Nurse%26nbsp;%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EProvide leadership, guidance and effectively manages the day-to-day operations of the Revenue Integrity Analyst, and Audit Nurses%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EEnsure timely review, appeal and follow up.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EAnalyze variances, rejections, and denials information to identify problems, trends and develop feedback and reports to be presented to senior management and clinical department heads.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EHospital Billing/Charge Accuracy audits (prospectively or retrospectively), Insurance Defense audits, select Focus audits, Billing Compliance and Charge Capture audits.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EProvides support to Patient Financial Services, HIM/Coding and departments to promote sound revenue integrity. Analyze data and develops an overall approach for trending issues, report findings, continued education and training (as the content experts) for PFS, clinical departments.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EThe Revenue Integrity manager provides management planning, development, and guidance to staff within the roles of Audit and Chargemaster.%26nbsp;%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EAnalyze data and develops an overall approach for trending issues, report findings, applying timely and constructive feedback, continued education, and training (as the %22content experts%22) for Revenue Integrity, clinical departments, nursing units/depts.%26nbsp; Prepares departments summaries based upon audit findings and works closely with applicable staff/management for continued performance improvement ensure compliance with Medicare/Medicaid regulations, Managed Care contractual agreements and the applicable policies of UT Southwestern University Hospital.%3C/span%3E%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EBENEFITS%3C/strong%3E%3Cbr%3EUT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:%3C/p%3E%3Cul%3E%3Cli%3EPPO medical plan, available day one at no cost for full-time employee-only coverage%3C/li%3E%3Cli%3E100% coverage for preventive healthcare-no copay%3C/li%3E%3Cli%3EPaid Time Off, available day one%3C/li%3E%3Cli%3ERetirement Programs through the Teacher Retirement System of Texas (TRS)%3C/li%3E%3Cli%3EPaid Parental Leave Benefit%3C/li%3E%3Cli%3EWellness programs%3C/li%3E%3Cli%3ETuition Reimbursement%3C/li%3E%3Cli%3EPublic Service Loan Forgiveness (PSLF) Qualified Employer%3C/li%3E%3Cli%3E%3Ca target=%22_blank%22 rel=%22noopener noreferrer%22 href=%22http://jobs.utsouthwestern.edu/benefits/#top%22%3ELearn more about these and other UTSW employee benefits!%3C/a%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3EEXPERIENCE AND EDUCATION%3C/strong%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3ERequired%3C/strong%3E%3C/li%3E%3Cli%3E%3Cstrong%3EEducation%3C/strong%3E%3Cbr%3EBachelor%27s Degree from a recognized college or university in business, healthcare or a closely related field or 10 years%27 of experience within the revenue cycle and coding.%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3E%3Cstrong%3EExperience%3C/strong%3E%3Cbr%3E10 years%27 Experience in the hospital setting, healthcare industry or coding with a focus in one or more of the following areas: coding, charge integrity; charge reconciliation; charge compliance; charge auditing; CDM management or Audit Nursing and%26nbsp;%3Cbr%3E1-year Supervisory experience%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3E%3Cstrong%3ELicenses and Certifications%3C/strong%3E%3Cbr%3E(RN) REGISTERED NURSE or%26nbsp;%3Cbr%3E(CPHT) CERT PHARMACY TECH or%26nbsp;%3Cbr%3E(PTCB) CERT COMPND STERILE PREP TECHN or%26nbsp;%3Cbr%3E(CHRI) CertHealthcareRevenueIntegrity professional certification through NAHRI or%26nbsp;%3Cbr%3E(RHIA) REGD HEALTH INFO ADMINIST professional certification through AHIMA or%26nbsp;%3Cbr%3E(RHIT) REGD HEALTH INFO TECHNOLO professional certification through AHIMA or%26nbsp;%3Cbr%3E(CCS) CERT CODING SPECIALIST professional certification through AHIMA or%26nbsp;%3Cbr%3E(COC) Certified Outpatient Coding professional certification through AAPC or%26nbsp;%3Cbr%3E(CPC) CERT PROFESSIONAL CODER professional certification through AAPC%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EPreferred%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cstrong%3EExperience%3C/strong%3E%3Cbr%3EEPIC HB/PB experience%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EJOB DUTIES%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3EOversees all revenue integrity staff with a focus on charge capture and charge reconciliation activities. Coordinates efforts with Sr. Nurse Auditor and Sr. Chargemaster Coordinator to lead audit/ charge evaluations according to RI auditing guidelines. Meets with departmental leadership to review findings, documentation standards and recommendations for improvement. Targeted populations are identified through random sampling, focused reviews, issues identified in collaboration with various site personnel, and rotation/selection of specific clinical areas. Audits include review of selected medical records documentation to determine accuracy of coding assignments, billing compliance, medical necessity and when appropriate collaborate with shared coding and financial departments to identify departments that require improved documentation.%3C/li%3E%3Cli%3EAnalyzes charge capture audit reports to verify that appropriate charges have been posted to patient accounts according to diagnosis and related procedure codes and that revenue has been routed/recorded in the appropriate department/cost center.%3C/li%3E%3Cli%3ECoordinates efforts with Sr. Nurse Auditor and Sr. Chargemaster coordinator to insure all staff are informed of all regulatory changes for both hospital billing and professional billing, conduct any necessary training and all policies are kept up to date assists departments with the charge reconciliation process. Works with all relevant hospital departments and professional billing%3Cbr%3Edepartments to provide timely education on how to correct or improve processes that have been found to be deficient.%3C/li%3E%3Cli%3EAdvises service line leaders and their staff on proper usage of charge codes; identifies opportunities for capturing additional revenue in accordance with payer guidelines; develops specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections for both hospital and professional billing.%3C/li%3E%3Cli%3EStay abreast of ongoing compliance trends and developments. Reports new developments to department. Plans and presents in-services to nursing, physician, and other clinical personnel regarding processes, updates and reviews relating to audit findings and/or regulatory compliance.%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3ESECURITY AND EEO STATEMENT%3C/strong%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3ESecurity%3C/strong%3E%3Cbr%3EThis position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.%3Cbr%3E%3Cbr%3E%3Cstrong%3EEEO%3C/strong%3E%3Cbr%3EUT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.%3Cbr%3E%26nbsp;%3C/p%3E Apply Now