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Job Description

Business Unit: Rush Medical Center

Hospital: Rush University Medical Center

Department: Revenue Cycle Revenue Integrit

**Work Type:** Full Time (Total FTE between 0.9 and 1.0)

**Shift:** Shift 1

**Work Schedule:** 8 Hr (7:00:00 AM - 3:00:00 PM)

Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits).

**Pay Range:** $50.39 - $90.20 per hour

Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Summary:

The Manager, Revenue Integrity RN will use collaboration, assessments, training skills, and clinical knowledge to ensure that patient charges are accurate while leading the team of nurses. This role will lead the nursing staff in their reviews charges and clinical documentation, initiates and leads performance improvement efforts, and educates clinical departments about charging while promoting revenue integrity. This nurse manager exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

Other information:

Required Job Qualifications:

• Current State of Illinois RN Licensure

• Associates or Bachelor’s degree in nursing

• Coding credential from AAPC or AHIMA (CCS, CCA, CPC, COC, CPMA, RHIT or RHIA)

• Epic Certification

• 2+ years of Revenue Integrity or Revenue Cycle experience

• 5+ years of clinical nursing experience using Epic software

• Mathematical skills related to pharmaceutical dose and unit calculations

• Understanding of clinical charging and the relationship to codes, edits, and proper charging

• Demonstrated ability to communicate clearly and effectively

• Strong interpersonal skills necessary for the communication and training of Revenue Integrity concepts

• Ability to perform multiple tasks with excellent time management skills

• Proficient in Microsoft Office, Excel, PowerPoint, and Word skills

Preferred Job Qualifications:

• Procedural nursing including Operating room, Labor and Delivery, Cath lab, Interventional Radiology, or Emergency Room

Physical Demands:

**Disclaimer:** The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

Responsibilities:

1. Lead the team that connects the Clinical Operations knowledge and experience to Revenue Integrity, charge description master (CDM), charge capture and metrics to ensure accurate revenue and reimbursement

2. Improves revenue results by optimizing and improving the clinical, operational, and revenue integrity processes related to patient charges

3. Build relationships within the revenue cycle, and engage clinical areas of the organization that serve as mutually beneficial partnerships, providing support as a clinical and charging subject matter expert with billing, patient access, and third-party billing audits

4. Reviews CPT/HCPCS descriptions and charges with clinical documentation to ensure compliant charging

5. Identifies services performed in the clinical department for individual patients that need to be built in the Charge Description Master (CDM)or be charged on a patient’s account based on CPT/HCPCS descriptions compared to clinical activities. Adjusts charges on patient accounts as needed.

6. Identifies chargeable supplies, implants, devices, and pharmaceuticals

7. Identifies and trouble-shoots charging, CDM, or clinical documentation issues and works with ancillary departments to resolve

8. Provides recommendations on cost-containment related to charges, for clinical areas

9. Contributes to internal controls to ensure compliance with charging regulations

10. Identifies patterns, trends, variances, and opportunities to improve charging accuracy

11. Engages clinical departments in revenue integrity; research code and charge questions as requested

12. Provides education to clinical departments to promote appropriate charge capture processes and documentation requirements for specific charge activity

13. Identify trends and lead performance improvement efforts through multi-disciplinary teams to streamline processes, enhance charging automation, train staff, and promote accuracy

14. Responsible for implementing short and long-term plans and objectives within set deadlines to ensure compliant coding practices, ensure claims timely filing, & reduce denials

15. Develop, update and implement job standards, job duties, job aids, departmental policies, and performance appraisals for all areas of responsibility. Engages in development and growth of self and the team

16. Collect, interpret, and communicate performance data using various tools and systems, while also using this data to make decisions on how to achieve performance and budgetary goals

17. Responsible for interviewing, hiring, orienting new team members (staff & temp), staffing, performance management and development of staff. Counsel and disciplines employees, when necessary, in accordance with department and/or organizational policies. Maintains staff schedules, timecards, and payroll with fiscal responsibility.

18. Prepares monthly analytics reports, dashboards information, and other statistics along with assisting in strategic planning

19. Facilitate a positive culture that exemplifies growth-minded practices, leadership, and industry-best practices

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

**Position** Manager Revenue Integrity RN

**Location** US:IL:Chicago

**Req ID** 23232