Manager Revenue Assurance RN
Aurora Health CareFull time
Manager Revenue Assurance RN
- Job ID: 195778PS
- Shift: 1
- Full/Part Time: Full Time
MKE 3355 W Frst Home Av –
Milwaukee, WI 53215
- Benefits Eligible: Yes
- Hours / bi-weekly pay period: 80
Provides leadership for the revenue assurance function in alignment with the AAH strategies. Provides key insights and recommendations for accurate revenue capture and audit processes to ensure compliance with federal and state regulation and payer contracts. Contributes to collaboration, integration, and performance improvement activities with revenue cycle and clinical leaders to achieve strategic, financial, and operations goals.
This position is remote and can be based in WI or IL or possibly out of state for the right candidate.
- Responsible for Managing the Revenue Assurance team toward researching and resolving regulatory and contract compliance issues with the compliance team and system leaders. Proactively reviews federal and state regulations and payer contracts/policies for necessary changes related to coding and billing practices. Collaborates with clinical leaders and communicates changes in charging and billing practices. Provides education and consultation for the systems clinical and finance team members for charge capture inquiries.
- Monitors reports and workqueues to identify patterns of charging variance to identify opportunities for improved revenue performance. Collaborates with clinical leaders to support expected charge performance and charge capture work flow.
- Sets direction and performance goals for the Revenue Assurance team to ensure charges are entered timely and accurately to reflect patient services provided.
- Develops and utilizes key data indicators to monitor processes in order to streamline workflow, design operations, and improve quality, service, and performance.
- Demonstrated knowledge of third party reimbursement programs, state and federal regulatory issues, and ICD9/CPT/HCPCs coding.
business hours with flexibility – Remote position
Licenses & Certifications
Registered Nurse RN license issued by the state in which the team member practices.
- Bachelor’s Degree in Health Care Administration or related field.
Required Functional Experience
- Typically requires 5 years of experience in operations management: clinical, revenue cycle, payer contracting, financial. Medical Audit experience is ideal.
Required Management Experience
- Includes 1 year of supervisory experience in operations management.
Knowledge, Skills & Abilities
- Hospital operations expertise; expert knowledge of process improvement methods.
- Hospital revenue cycle operations and systems.
- Demonstrated leadership skills and ability to manage multiple priorities in a dynamic work environment.
- Strong analytical, decision-making and prioritization skills, systems thinking, flexibility.
- Excellent, effective written and verbal communications skills. Excellent public relations skills.
- Ability to work well within a team atmosphere while recognizing and meeting the individualized needs of customers and internal partners.
- Excellent interpersonal, negotiation, diplomatic, problem-solving skills with the ability to successfully and positively interact with individuals across all hierarchical levels within the organization, as well as outside partners (e.g., insurance/payer representatives).
- Knowledge of hospital reimbursement, hospital managed care contracts; government payer reimbursement regulations. Knowledge and experience using Hospital clinical systems and Microsoft applications.
- Knowledge of Hospital coding: HCPCS, CPT, Revenue Codes, DRGs; experience with hospital charge description masters (CDMs).