Revenue Integrity Team Leader (Hybrid)

Job Posted 2 Days Ago Posted 2 Days Ago
Be an Early Applicant
Wilmington, DE
Senior level
Healthtech • Pharmaceutical • Hospitality
The Role
The Revenue Integrity Team Leader at ChristianaCare coordinates charge capture initiatives, ensuring compliance with regulations and payer policies, particularly during the EMR transition from Cerner to EPIC. Responsibilities include monitoring adherence to billing processes, leading staff meetings, training programs, and conducting analyses to identify revenue cycle opportunities.
Summary Generated by Built In

Job Details

Are you looking for a career opportunity working for a healthcare organization that is based on excellence and love?

ChristianaCare is one of the country's most dynamic healthcare organizations, centered on improving health outcomes, making high-quality care more accessible, and lowering healthcare costs. ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care, and women's health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as the Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.

About This Position

ChristianaCare is searching for a Revenue Integrity Team Lead to be responsible for coordinating and implementing complete, correct, timely and compliant charge capture initiatives and processes. The Lead will be responsible for adhering to all government regulations and payer policies when developing charge practices in coordination with service line leaders.

PLEASE NOTE: This position is hybrid and is in-office 1-2 days per week or as needed.

Principal duties and responsibilities:

  • Monitor revenue generating departments adherence to charge reconciliation processes and metrics measured by key performance indicators
  • Integral to success of EMR transition from Cerner to EPIC as it relates to compliant charging
  • Ensure changes within the charge description master (CDM) coincide and are implemented within clinical systems
  • Lead annual, quarterly, and regular CDM maintenance activities
  • Review changes in CPT, HCPCS, and revenue codes for accuracy, compliance with applicable billing guidelines, and optimization of reimbursement
  • Develop, deliver, and revise education and training programs in coordination with the revenue integrity manager
  • Monitor, investigate, and resolve revenue integrity concerns reported in their area and provide any necessary follow-up
  • Monitor national, state, and local information to keep current with applicable regulatory and legislative changes and implement necessary updates
  • Lead weekly revenue integrity staff meetings to track progress toward work plan activities and reactive tasks
  • Develop tools to track and identify potential areas of lost revenue
  • Serves as a subject matter expert and in a consultative role to various levels of customers; works closely and collaboratively with Clinical Department Leaders.
  • Responsibilities include all aspects of Revenue Cycle support including performance improvement, development, documentation, testing, training and upgrades. Assist management in examining processes to improve workflow.
  • Reviews, monitors, and facilitates implementation of billing and coding changes affecting charge capture processes in accordance with payer requirements.
  • Provides guidance and education to billing and clinical department staff related to appropriate documentation requirements, denials resolution, and regulatory requirements relevant to charging, coding and billing.
  • Compiles and analyzes data from various sources to develop recommendations leading to potential revenue cycle opportunities, including analyses related to CDM set-up, charge capture, billing and/or patient financial services.
  • Conducts and leads special projects to facilitate revenue management as required for new facilities/acquisitions, new departments, new service lines, changes in regulations, etc.
  • Implements charge capture corrective measures and monitoring tools to ensure sustainability of changes; performs, reviews, and monitors statistics and key performance indicators to identify improvement opportunities.
  • Coordinates all activities of the charge description master including but not limited to, charge creation, charge validation, charge analysis and pricing.
  • Conducts root-cause analyses with others to identify opportunities for error reduction.
  • Facilitates and manages the annual review and updates to the Charge Description Master and pricing file.
  • Builds strong relationships and facilitates productive communication between key stakeholders and Clinical departments. Collaborates with others to develop and implement action plans to resolve charge errors.
  • Researches regulatory requirements relevant to charges, monitors trends, and maintains knowledge of charge-related regulations and standards. Applies knowledge to ensure that charges are accurate, billed correctly, and supportable according to payer and regulatory requirements.

Education and experience requirements:

Bachelor’s degree from an accredited college in a relevant field of study required.

Coding Certification (CPC, COC, CCS) required. Uncertified candidates with the appropriate combination of education and experience will be allowed one (1) year from the date of hire to obtain certification.

Equivalent and relevant combination of education and experience may be considered in lieu of Bachelor’s degree.

Five years of revenue cycle management and/or revenue integrity experience in a healthcare environment required.

Post End DateMar 31, 2025

EEO Posting Statement

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Top Skills

Cerner
Cpt
Emr
Epic
Hcpcs
Am I A Good Fit?
beta
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

The Company
New Castle, Delaware
8,152 Employees
On-site Workplace

What We Do

Headquartered in Wilmington, Delaware, ChristianaCare is one of the country’s most dynamic health care organizations, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs.

ChristianaCare includes an extensive network of primary care and outpatient services, home health care, urgent care centers, three hospitals (1,336 beds), a freestanding emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health. It also includes the pioneering Gene Editing Institute.

ChristianaCare is nationally recognized as a great place to work, rated by Forbes as the 2nd best health system for diversity and inclusion, and the 29th best health system to work for in the United States, and by IDG Computerworld as one of the nation’s Best Places to Work in IT. ChristianaCare is rated by Healthgrades as one of America’s 50 Best Hospitals and continually ranked among the nation’s best by U.S. News & World Report, Newsweek and other national quality ratings. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. With its groundbreaking Center for Virtual Health and a focus on population health and value-based care, ChristianaCare is shaping the future of health care

Similar Jobs

Capital One Logo Capital One

Manager, Supplier Management

Fintech • Machine Learning • Payments • Software • Financial Services
Hybrid
6 Locations
55000 Employees
133K-182K Annually
Hybrid
Wilmington, DE, USA
289097 Employees
Hybrid
Wilmington, DE, USA
289097 Employees
Hybrid
Wilmington, DE, USA
289097 Employees

Similar Companies Hiring

Mochi Health Thumbnail
Telehealth • Healthtech
San Francisco, CA
70 Employees
Cencora Thumbnail
Pharmaceutical • Logistics • Healthtech
Conshohocken, PA
46000 Employees
Stepful Thumbnail
Software • Healthtech • Edtech • Artificial Intelligence
New York, New York
60 Employees
By clicking Apply you agree to share your profile information with the hiring company.

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account