Revenue Integrity Manager

Wilshire hires only the brightest and most experienced professionals in the healthcare revenue cycle management industry.  Wilshire will take the time to get know you and your employment history.  We will then place you in a role that will lead to a path of career success.  

About The Wilshire Group

The Wilshire Group is a boutique consulting firm in Los Angeles, California.  Our firm focuses on revenue cycle optimization as well as bringing a strong leadership team as the voice between operations and IT.  Our team has worked with over 100 healthcare systems across the US.  

 Our Values

• To be professional | To be efficient | To be flexible

This position offers $55-$70 per hour.  This is a contracted position for 6+ months.

POSITION SUMMARY

The Revenue Integrity Manager plays an important role in leading a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions, and interdependencies from the provision of patient care to final bill generation. This position will provide guidance and expertise not only to existing CDM and Revenue Integrity staff, but to facility and clinic department leaders to support the entire health system. Due to its service focus and project management emphasis, this position requires strong organizational, interpersonal, and communication skills.  This position requires well-developed analytic, research, and data management skills and must possess a strong grasp of payor contract processes in order to maximize reimbursement.

POSITION DUTIES

• Reviewing, identifying, and analyzing necessary CPT changes related to quarterly and annual AMA CPT updates and regulatory changes by timelines set.
• Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications. Executes on work plans to adapt systems and processes to accommodate changes.
• Processing CDM requests received from the clinical departments, or others, researching references and regulations to ensure correct coding and charging through the CDM. Assigns charge codes as requested by revenue producing clinical departments and practices, working within system wide policies and procedures and with direction from Revenue Integrity Liaisons.
• Works with Revenue Integrity Liaisons and clinical departments and practices to create new CDM items and pricing for new services and items.
• Provides mentoring, guidance, and expertise to CDM Coordinator role and assists in development of individuals in all CDM efforts.

JOB SPECIFICATIONS

Education: Bachelor’s Degree

Experience: 3 Prior Years’ Experience as CDM Coordinator or Equivalent Related Experience

License/Certification CPC, CPC-H, CCS, CCSP, PMP

Special Skills/Training

Knowledge of Epic electronic medical record and financial system.

Wilshire is honored that you have taken the time to review/apply to our open position.  We will now take the time to review your experience and be in touch with you soon.