Sinai Chicago Manager Revenue Integrity

General Summary/basic PURPOSE OF JOB:

The Revenue Integrity Manager is a key role instilling a culture of Revenue Cycle discipline with our clinical partners. The Revenue Integrity Manager is responsible for coding education for our clinicians and ensuring compliance with government, payer and internal charge capture policies for both Technical (Facility) and Professional Services in a manner that optimizes revenue generation.

The Revenue Integrity Manager conducts reviews of EMR documentation of patient encounters to ensure coding accuracy and documentation adequacy. Working collaboratively with the coding team and ensuring provider education to our clinicians to support revenue integrity while identifying trends and opportunities for coding optimization. Provide feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding, regulatory and/or payer updates.

The Revenue Integrity Manager will consistently demonstrate support of Sinai Health Systems Mission, Vision and Core Values by contributing to the team efforts and showing respect for and compassion for patients and their families, fellow employees, and all others with whom there is a contract in or in the interest of the organization.

• Bachelor’s Degree

• 5 years of Revenue Cycle related experience (i.e., Coding, CDI, CDM, PFS) is required.

• Two years of E/M and/or surgical coding experience
• Prior experience with billing and claims processing
• Prior experience working in a hospital or clinic setting
• Proficient in Excel, Word, Data Entry, computerized healthcare billing software knowledge, experience in Epic Ambulatory
• Knowledge of federal, state and payer-specific regulations and policies pertaining to documentation, coding, and billing, with demonstrated ability to interpret such guidelines
• Strong communication and organizational skills

• Certified Professional Coder (CPC) or Certified Coding Specialist-Physician Based (CCS-P)
• Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification in conjunction with physician-based coding experience, may be considered contingent upon CPC or CCS-P certification being acquired within the first 6 months of employment.