Revenue Integrity Manager

Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Children’s Hospital of Michigan, we’re seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.

Benefits Statement

At Tenet Healthcare, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include\:
• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off (PTO)
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.

Note\: Eligibility for benefits may vary by location and is determined by employment status

Job Summary

Reports to the Director Revenue Analysis and manages the revenue analysis function for the assigned hospital and ambulatory sites. Responsible for preparation and completion of eReserve. Responsible for the analysis of eReserve and items/trends that significantly impact net revenue. Responsible for the review and approval of manual adjustments and refunds. Monitors/analyzes AR/Disputes and assists with Bad Debt Initiatives.

Monitors and communicates non-reimbursable charges (e.g., ABN not signed, denials, disputes, bad debt). Reviews proposed managed care contracts and identify any issues or concerns with implementation of the terms prior to the contract being finalized. Assists in analyzing data to verify contract terms have been loaded correctly into IMaCs and claims properly adjudicated during and after managed care negotiations.

Monitors/reviews billing, A/R and reconciliation for hospital specific contracts (e.g., non-IMaCs, local employer). Works with hospital departments to resolve revenue cycle issues (e.g., orders, charging, Patient Access, DNFB, DNSP, QS, disputes). Works with hospital leadership on revenue cycle issues. Works with hospital related entities (e.g., clinics, universities), if applicable.

Facilitates revenue cycle meetings (preparation, facilitation and follow-up). Supports/directs/monitors the following\: department head meetings, chart audit meetings, compliance committees, charge master review/updates, pass through invoice retrieval, complex (e.g., 'High $" or "At-Risk") in-house patient meetings, hospital revenue cycle implementation initiatives, internal/external Audit Assistance, engaging legal for collection Issues.