Jobs
>
Houston

    Revenue Integrity Manager - Houston, United States - Nexus Health Systems Ltd

    Nexus Health Systems Ltd
    Nexus Health Systems Ltd Houston, United States

    2 weeks ago

    Default job background
    Description

    Job Description

    Job Description

    POSITION SUMMARY:

    Under general direction from the Corporate Director, Revenue Cycle – the Manager, Revenue Integrity leads organizational initiatives related to Chargemaster, Facility Coding, Professional Coding, Charge Capture, Charge Reconciliation, Physician Documentation, Payer-specific Coding Requirements, and/or State-specific Coding Requirements. The Manager of Revenue Integrity will develop and maintain relationships with external and internal stakeholders and foster improvements collaboratively across the organization.

    JOB SPECIFIC RESPONSIBILITIES:

    • Maintain utmost level of confidentiality at all times.
    • Adhere to health system policies and procedures.
    • Demonstrate ethical business practices and personal actions and adhere to corporate compliance and integrity guidelines.
    • Maintains a sense of professionalism and self-validation.
    • Ability to communicate effectively with all stakeholders across the health system.
    • Responsible for promoting adherence to applicable State/Federal laws and regulations and the program requirements of accreditation agencies and Federal/State and private health plans in requests for third-party reimbursement.
    • Evaluate the use of Revenue Cycle electronic systems and offer recommendations to maximize reporting and revenue integrity accuracies.
    • Acts as a Revenue Integrity liaison with various IT teams handling various EMR modules to set up and maintain accurate charges flow.
    • Coordinates the administrative, legal, operational, and financial issues related to Revenue Integrity data with appropriate departments
    • Participate and lead the development and management of Revenue Integrity projects, workflows, and application builds.
    • Assist with the strategic and financial judgment necessary for profitable organizational growth.
    • Responsible for timely research and evaluation of Medicaid and Medicare regulations, as well as Commercial Payer regulations and changes to optimize reimbursement
    • Supports and participates in continuously assessing and improving the quality of care and services provided.
    • Performs Inpatient and Outpatient coding, including, but not limited to, DX, DRG, CPT, HCPCS, Modifiers, etc.
    • Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations.
    • Audits clinical documentation and coded data to validate documentation support services rendered for reimbursement and reporting purposes.
    • Participate in denials and appeals related to coding or clinical documentation.
    • Develop and maintain a Revenue Integrity policy and standard operating procedures.
    • Develop and maintain a Charge Description Master (CDM) for administered services and procedures.
    • Identifies KPIs for Revenue Integrity initiatives and collaborates with key stakeholders towards process improvements.
    • Identifies and interprets trends and patterns within Revenue Integrity and recommends resolution
    • Participate in new service or business line research and assessments.
    • Assists and participates in the development of department policies.
    • Develops and maintains revenue Integrity reporting.
    • Perform extensive data mining and testing of financial and clinical information from various decision support tools and software, as needed, for effective and accurate department reporting.
    • Maintains positive working relationships with other organizational departments such as Accounting & Finance, HIM, Compliance, and the Medical Staff to ensure the departments' responsibilities are performed expeditiously and thoroughly.
    • Performs other duties as assigned.

    POSITION QUALIFICATIONS:

    EDUCATION:

    • Associate's Degree in Nursing (RN) or Bachelor of Science in Nursing (BSN)

    EXPERIENCE:

    • Minimum three years experience in the same or similar position.

    LICENSURE/CERTIFICATION:

    • Current Core Inpatient Coding Certification from AAPC or AHIMA, such as CIC or CCS
    • CPP desired
    • Must pass a criminal background check on an annual basis.
  • Enterprise Products

    Manager, Mechanical Integrity

    3 weeks ago

    Enterprise Products Houston, United States

    Enterprise Products Partners L.P. is one of the largest publicly traded partnerships and a leading North American provider of midstream energy services to producers and consumers of natural gas, NGLs, crude oil, refined products and petrochemicals. Our services include: natural g ...

  • Kinder Morgan

    Manager-project Management Integrity

    2 weeks ago

    Kinder Morgan Houston, United States

    Kinder Morgan is one of the largest energy infrastructure companies in North America. We own an interest in or operate approximately 82,000 miles of pipelines and 140 terminals. Our pipelines transport natural gas, gasoline, crude oil, carbon dioxide (CO2) and more. Our terminals ...

  • Jayes Tech LLC

    Data Integration Project Manager

    2 weeks ago

    Jayes Tech LLC Houston, United States

    **Job Title: Product Manager** · **Location: Houston, TX** · **Duration: 12+ Months contract** · **Domain: Energy | Oil & Gas | Utility | Petrochemicals** · As Product Manager, is the IT Lead responsible for managing an individual IT Product, working closely with the Product Owne ...

  • Western Midstream

    Project Services Manager, Pipeline Integrity

    4 days ago

    Western Midstream The Woodlands, United States

    Location: The Woodlands, TX, US, Req ID: 2068Western Midstream is a master limited partnership formed to own, develop, acquire, and operate midstream assets. We are engaged in the business of gathering, compressing, treating, processing, and transporting natural gas; gathering, s ...

  • Insight Global

    Integrity systems Manager

    1 week ago

    Insight Global Houston, United States

    A top midstream oil & gas company in Houston, TX, is seeking an Integrity Systems Manager to join their Pipeline Integrity group. This individual will be responsible for developing, implementing, and maintaining applications and databases generally focused on the company's Integr ...

  • Nexus Health Systems

    Revenue Integrity Manager

    6 days ago

    Nexus Health Systems Houston, United States

    POSITION SUMMARY: · Under general direction from the Corporate Director, Revenue Cycle - the Manager, Revenue Integrity leads organizational initiatives related to Chargemaster, Facility Coding, Professional Coding, Charge Capture, Charge Reconciliation, Physician Documentation, ...

  • Enterprise Products Partners

    Manager, Mechanical Integrity

    4 days ago

    Enterprise Products Partners Houston, United States

    The Manger, Mechanical Integrity is responsible for implementing the Facility Mechanical Integrity Program in Houston Texas. Responsibilities include, but are not limited to: Responsible for implementing the Facility Mechanical Integrity Program Hous Mechanical, Manager, Mechanic ...

  • Nexus Health Systems

    Revenue Integrity Manager

    1 week ago

    Nexus Health Systems Houston, United States

    POSITION SUMMARY:Under general direction from the Corporate Director, Revenue Cycle - the Manager, Revenue Integrity leads organizational initiatives related to Chargemaster, Facility Coding, Professional Coding, Charge Capture, Charge Reconciliation, Physician Documentation, Pay ...

  • Enterprise Products

    Manager, Mechanical Integrity

    3 weeks ago

    Enterprise Products Houston, United States

    · Enterprise Products Partners L.P. is one of the largest publicly traded partnerships and a leading North American provider of midstream energy services to producers and consumers of natural gas, NGLs, crude oil, refined products and petrochemicals. Our services include: natura ...

  • EPCO Corporate

    Manager, Mechanical Integrity

    3 weeks ago

    EPCO Corporate Houston, United States

    Enterprise Products Partners L.P. is one of the largest publicly traded partnerships and a leading North American provider of midstream energy services to producers and consumers of natural gas, NGLs, crude oil, refined products and petrochemicals. Our services include: natural g ...

  • Epco Corp

    Manager, Mechanical Integrity

    2 weeks ago

    Epco Corp Houston, United States

    Manager, Mechanical Integrity - 000EM8 Description Enterprise Products Partners L.P. is one of the largest publicly traded partnerships and a leading North American provider of midstream energy services to producers and consumers of natural gas, NGLs, crude oil, refined products ...

  • Insight Global

    Integrity Systems Manager

    2 days ago

    Insight Global Houston, United States

    A top midstream oil & gas company in Houston, TX, is seeking an Integrity Systems Manager to join their Pipeline Integrity group. This individual will be responsible for developing, implementing, and maintaining applications and databases generally focused on the company's Integr ...

  • Insight Global

    Integrity Systems Manager

    1 week ago

    Insight Global Houston, United States

    A top midstream oil & gas company in Houston, TX, is seeking an Integrity Systems Manager to join their Pipeline Integrity group. This individual will be responsible for developing, implementing, and maintaining applications and databases generally focused on the company's Integr ...

  • ARES Corporation

    Risk Management Integrator

    3 weeks ago

    ARES Corporation Houston, United States

    Job Description · Job DescriptionARES is looking for an individual with experience in risk management to join our team supporting the Human Spaceflight Technical Integration Contract at the Johnson Space Center. The risk management candidate will facilitate the identification and ...

  • Kinder Morgan

    Manager-Project Management Integrity

    2 weeks ago

    Kinder Morgan Houston, United States

    Position Description · Kinder Morgan is one of the largest energy infrastructure companies in North America. We own an interest in or operate approximately 82,000 miles of pipelines and 140 terminals. Our pipelines transport natural gas, gasoline, crude oil, carbon dioxide (CO2) ...

  • Velocity Ventures

    Personal and Integration Manager

    2 days ago

    Velocity Ventures Meadows Place, TX, United States Freelance

    HEY YOU You see yourself as a trusted person for colleagues and love intercultural exchange? You are passionate about the successful, long-term integration of foreign employees and colleagues? Perfect, because we are still on the fast lane, want to grow and are looking for a **Pe ...

  • Energy Transfer

    Project Manager- Mechanical Integrity

    2 weeks ago

    Energy Transfer Houston, United States

    Energy Transfer is one of the largest and most diversified midstream energy companies in North America with approximately 120,000 miles of pipelines and associated energy infrastructure across 41 states transporting the oil and gas products. The Project Manager will support Energ ...

  • Insight Global

    Project Manager, Pipeline Integrity

    2 weeks ago

    Insight Global The Woodlands, United States

    A midstream energy provider is hiring a Project Manager who is responsible for the Pipeline Integrity Management Program projects for gas and hazardous liquid pipelines. The Project Manager will provide scope, schedule, and budget guidance for pipeline integrity working with the ...

  • Abyss Solutions

    Project Manager, Asset Integrity

    3 weeks ago

    Abyss Solutions Houston, United States

    Location: Houston, TX, USA · About the role · Abyss is looking for a client facing Project Manager (PM) to support our Asset Integrity Portfolio. As a Project Manager at Abyss, you will be servicing products that have some form of field data collection, analysis, and engineerin ...

  • American Bureau of Shipping (ABS)

    Asset Integrity Technical Manager

    3 weeks ago

    American Bureau of Shipping (ABS) Houston, United States

    The Technical Manager has overall responsibility for the technical execution of individual projects within the Technical Marine and Field Services group. This group conducts surveys and analyses to determine the integrity of assets in the marine, offshore, and onshore markets. Th ...