Supervisor Revenue Integrity - Acute Charge Control

Trinity Health Of New England - Hartford, CT

Full-time - Mid Level

Hartford, CT

Hospitals

About the position

Trinity Health of New England has an exciting opportunity to join our team as a Supervisor of Revenue Integrity. The Supervisor provides day-to-day operational supervision for local hospital and/or Medical Group Provider Services revenue integrity functions. This role is crucial in motivating staff to achieve the highest levels of performance while working in conjunction with all key stakeholders and varying levels of leadership to prevent revenue leakage and maximize potential revenue for the region. The Supervisor will oversee the Charge Description Master (CDM), revenue integrity pre-bill edits, root cause analysis, denials coordination with the Patient Business Service (PBS) center, including complex case denials, denial prevention, audits, and the education and training of multi-disciplinary teams. In this position, the Supervisor is responsible for optimizing staff performance through process redesign, policy/procedure implementation, communications, continuing education, and professional development activities. Empowering staff and providing constructive feedback are also key components of this role. The Supervisor will collaborate with Revenue Integrity leadership and Payer Strategies to ensure a thorough understanding of payer contracts, the application of contract terms, and alignment with processes. Additionally, the Supervisor will monitor all Medicare and Medicaid websites, as well as other payer websites and newsletters, to stay updated on medical policies and changes that impact charging, compliance, coding, and billing. The role also involves providing education to departments and colleagues on audit and root cause analysis findings, regulatory changes and requirements, coding updates, and payer billing requirement changes. This position is essential for maintaining the integrity of revenue processes and ensuring compliance with all relevant regulations and standards.

Responsibilities

• Supervises the Charge Description Master (CDM) and revenue integrity pre-bill edits.
• Conducts root cause analysis and coordinates denials with the Patient Business Service (PBS) center.
• Prevents denial occurrences and conducts audits.
• Educates and trains multi-disciplinary teams on revenue integrity processes.
• Optimizes staff performance through process redesign and policy/procedure implementation.
• Collaborates with Revenue Integrity leadership and Payer Strategies to ensure understanding of payer contracts.
• Monitors Medicare and Medicaid websites for updates on medical policies and changes.
• Provides education on audit findings, regulatory changes, and coding updates.

Requirements

• Must possess a comprehensive knowledge of Hospital and Physician Practice operations.
• Minimum of three (3) years of progressively responsible experience in revenue cycle operations or equivalent education and experience.
• Associate's degree preferred.
• Supervisor or team leader experience preferred.
• Knowledge and experience in Revenue integrity in an acute care and/or Physician practice setting.
• Licensure/Certification: RHIA, RHIT, CCS, CPC/COC, or other coding credentials strongly preferred.
• CDC (Healthcare Compliance Certification) preferred.
• Experience in Charge Description Master (CDM) maintenance is strongly preferred.

Nice-to-haves

• Experience in healthcare compliance certification (CDC).
• AAPC Certification.

Benefits

• Excellent Benefits effective on 1st Day
• Engaged leadership
• Remote Capability
• Full Time: Monday - Friday Eastern Standard time hours required.