Revenue Integrity Manager - Business Dept. (Full-Time Days) in Hickory, NC at Frye Regional Medical Center

Date Posted: 10/14/2018

Job Snapshot

Job Description

Frye Regional Medical Center

As a part of Duke LifePoint Healthcare, our community hospital is being supported with more resources than ever before. Duke LifePoint combines Duke University Health System's unparalleled expertise in clinical excellence, quality and patient safety with LifePoint Health's financial resources and extensive operational experience - making our hospital even stronger. 

Duke LifePoint Healthcare's pledge to our hospital and the communities we serve is quality, expertise and commitment.

•         Quality is the cornerstone of Duke LifePoint, and it is the central focus of everything the organization and our hospital strive to achieve. 

•         Duke LifePoint pledges to bring a wealth of expertise and resources to strengthen the already excellent care our hospital delivers. 

•         And, Duke LifePoint's commitment is to work collaboratively with our hospital to make our community healthier by strengthening local healthcare delivery for the future.  

For more information about Duke LifePoint, visit www.dukelifepointhealthcare.com


Job Description:

  • Perform periodic CDM review and analysis
  • Conduct daily charge capture audit and education in high performing areas (i.e., Observation, Surgery, ED, Injection and Infusions, etc)
  • Develops and delivers charge capture education to hospital staff
  • Actively participates in the development and implementation of performance improvement program for charge capture
  • Maintains responsibility for ensuring integrity of the documents that support patient billing
  • Reviews claim denials and rejections pertaining to billing, authorization, coding and documentation requirements.
  • Provides periodic updates to the CFO, CNO, BOD, Department Directors for appropriate action based on areas of highest risk associated with missing or inappropriate charge capture.
  • Provides detailed information from charge capture reviews when specific departments or areas are identified with under/over charging issues.
  • Serve as Revenue Integrity SME for charging and documentation
  • Keep abreast of APC, CPT changes to ensure preparation for outpatient prospective reimbursement by identifying areas affected and working to ensure compliance
  • Assist with oversight of Charge Master
  • Maintains current knowledge of insurance plans and government programs in order to ensure compliance with current hospital policies and procedures and how these proposed changes in regulations will impact the institution and disseminates the information to hospital staff.
  • Maintains working knowledge of the flow of information for the billing process and the clinical documentation that provides support to the billing process
  • Provides guidance to departments in reducing late charge report totals

Job Requirements

  • Associates degree required
  • Bachelors Degree and RHIA, RHIT, CPC, CPC-H certifications preferred
  • Minimum of 2 - 3 years Revenue Integrity/Charge Capture experience
  • If the minimum education/experience is a combination of education and experience, the employee must acquire the AAPC CPC-H credential from the American Academy of Professional Coders (AAPC) within one year of hire or transfer
  • Knowledge of electronic documentation systems


Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran