Revenue Management Specialist

Job Summary

We are seeking an experienced Revenue Management Specialist to oversee and manage charge capture initiatives, ensure revenue protection, and facilitate effective communication among teams. This role requires strong leadership skills, with direct interaction with executive level staff, and the ability to educate team members on Charge Description Master (CDM) processes.

Key Responsibilities:

• Manage a team of professionals responsible for evaluating, reviewing, planning, implementing, and reporting on revenue management strategies.
• Evaluate and maintain workflow processes to optimize CDM interfaces, billing edit resolution, and charge capture processes.
• Research and interpret regulatory guidance to ensure optimal revenue management practices.
• Provide incident management and problem resolution, identifying enterprise-wide solutions and implementing recommendations.

Fiscal Responsibilities:

• Monitor and explain expense variances to budget.

Supervisory Responsibilities:

This position carries out supervisory responsibilities in accordance with guidelines, policies, and procedures. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

• No. Direct Reports Charge Review Specialist I-II, Revenue Integrity Analyst I-III, Charge Audit Specialist

Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

• Strong interpersonal communication and presentation skills, effectively presenting information to executives, management, facility groups, and/or individuals.
• Ability to present ideas effectively in formal and informal situations; conveys thoughts clearly and concisely.
• Ability to respond in a professional manner to complex inquiries from various levels of personnel.
• Accepts personal responsibility for the quality and timeliness of his/her work; establishes due dates for projects and assignments and meets those dates; efficiently organizes activities.
• Ability to define problems, collect data, establish facts, draw valid conclusions, and make recommendations for improvement.
• Adapts easily to changing conditions and work responsibilities; works well with people of vastly differing levels, styles, and preferences.
• Understands external and internal drivers affecting revenue management.
• Ability to read, review, analyze, and interpret a variety of state/federal regulatory information and managed care contracts and their impact on appropriate claims production.
• Ability to utilize and research various published resources, appropriate reference materials, Internet resources, seminars, and other associated information sources to continually stay abreast of changes in regulatory information.
• Working knowledge in MS Office Applications (Excel, Word, Access, PowerPoint).

Education/Experience:

• Bachelor's degree or higher; related experience may be considered in lieu of degree.
• Prior supervisory experience required.
• Minimum of five years healthcare-related experience required.
• Working knowledge of laws and regulations pertaining to healthcare industry required.
• Prior healthcare financial experience or related field experience in a hospital/integrated healthcare delivery system required.
• Prior CDM or charge capture experience required.
• Consulting experience a plus.

Certificates/Licenses/Registrations:

• Applicable clinical or professional certifications and licenses such as LVN, RN, RT, MT, RPH, CPC-H, CCS highly desirable.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

• While performing the duties of this job, the employee is regularly required to sit for long periods of time; use hands and fingers; reach with hands and arms; talk and hear.
• Must frequently lift and/or move up to 25 pounds.
• Specific vision abilities required by this job include close vision.
• Some travel required.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• Normal corporate office environment.

As a healthcare leader, you will play a key role in shaping the future of patient care and outcomes. If you're passionate about delivering high-quality services and making a difference in the lives of others, we encourage you to explore this opportunity further.

Compensation and Benefits:

Compensation:

• Pay: $81,122.00 annually.
• Position may be eligible for an Annual Incentive Plan bonus of 10%-25% depending on role level.
• Management level positions may be eligible for sign-on and relocation bonuses.

Benefits:

• Medical, dental, vision, disability, life, and business travel insurance.
• Management time off (vacation & sick leave) – min of 12 days per year.
• 401k with up to 6% employer match.
• 10 paid holidays per year.
• 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, AD&D, auto & home insurance.
• For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.

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