• Operations Manager, Revenue Integrity (Full-Time,…

    Queen's Health System (Honolulu, HI)


    RESPONSIBILITIES

    I. JOB SUMMARY/RESPONSIBILITIES:

    • Supervises clinical and financial processes to improve revenue results, ensure integrity, and safeguard The Queen’s Health Systems (QHS) medical facilities against exposure and penalties.

    • Provides oversight of the charge capture processes across QHS to ensure that all valid charges are captured in the billing process in a timely and compliant manner.

    • Identifies charge compliance issues and root causes of noncompliance. Ensures correction of issues and develops changes to workflow processes to ensure that issues are prevented in the future.

    • Ensures operations and functions are in compliance with regulatory requirements and policies and procedures of QHS.

    • Prepares and presents financial reports for executive management review.

    II. TYPICAL PHYSICAL DEMANDS:

    • Seeing, hearing, speaking, finger dexterity.

    • Frequent: sitting.

    • Infrequent: walking, stooping/bending, reaching at and below shoulder level.

    III. TYPICAL WORKING CONDITIONS:

    • Not substantially subjected to adverse environmental conditions.

    IV. MINIMUM QUALIFICATIONS:

    A. EDUCATION/CERTIFICATION AND LICENSURE:

    • Bachelor’s degree in Business Administration, Finance, Health Care Administration or related field; or four (4) years of progressive experience in revenue cycle or finance may be substituted for the educational requirement.

    • Master’s degree in a related field preferred.

    B. EXPERIENCE:

    • In addition to the educational requirement, four (4) years of experience in two (2) or more of the following revenue cycle areas: revenue integrity, charge capture, facility or professional coding, billing, compliance, or pricing and reimbursement, preferably in a comparable organization.

    • One (1) year, supervisory/leadership experience.

    • Experience to demonstrate the following:

    o Working knowledge of charge master principles and the relationship to coding, billing and compliance in a hospital setting.

    o Knowledge of contracts, financial analysis methods, accounting principles and health care delivery systems.

    o Knowledge of requirements specific to government-funded health care program and third-party payer reimbursement.

    o Proficiency with computer-based hospital billing/records applications and Microsoft Office applications, i.e. Word and Excel.

    • Prior experience with Epic systems preferred.

     

    Equal Opportunity Employer/Disability/Vet