CarolinaEast Health System

Job Description

Job Summary: The Manager of Reimbursement & Revenue Integrity is responsible for supporting the enhancement and maintenance of properly functioning revenue cycle processes for CarolinaEast, which includes assistance with the integrity of the revenue charge capture system. In addition to supporting efficient revenue cycle functions, this individual assists with the management of an evolving centralized prior authorization process to achieve a high standard of accuracy and efficiency while contributing to the organization’s overall financial performance.

About CarolinaEast Health System

CarolinaEast Health System is committed to providing high quality, compassionate care across the Coastal Carolina region. At the heart of our system is a 350-bed, full-service medical center equipped with a comprehensive range of inpatient and outpatient services, utilizing the latest medical technologies. We employ over 3,200 dedicated team members and operate physician practices across various specialties in four counties. Our employees foster a culture of excellence that ensures our patients receive the same high level of care found at larger medical centers, all while maintaining a friendly, community-centered atmosphere throughout our facilities. CarolinaEast offers a robust benefits package to all full-time employees, as well as benefits for part-time plus and part-time staff. We are proud to be the first medical center in North Carolina recognized as a Cardiovascular Center of Excellence by the American College of Cardiology and the American Heart Association. Additionally, we are honored to be named one of America’s Best-In-State Hospitals by Newsweek, among numerous other prestigious accolades.

Minimum Requirements:

• Bachelor’s or Associate’s degree from a recognized college or university in business, healthcare, or a closely related field. A Master’s degree in a business related field is preferred.
• Five-seven years’ experience in Patient Financial Services, healthcare accounting, Managed Care, Reimbursement, or third party payer work.
• An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be submitted for the above education and experience requirements.
• Knowledge and understanding of end to end hospital revenue cycle operations (registration, charge capture, health information management, claims, third party payers’ patterns and policies, payment posting, denials management and prevention).
• Highly proficient in the use of Microsoft Word, Excel, PowerPoint, and Outlook; Windows Operating system, Internet. Experience in EPIC preferred.
• Intermediate proficiency with Adobe Acrobat.
• Experience with Structured Query Language (SQL), Visual Basic (VBA) and HTML as well as a demonstrated ability to learn query languages and programming.
• Ability to analyze and interpret large data sets. Ability to translate complex data into digestible information for its intended audience.
• Deliver outstanding customer service that upholds CarolinaEast's Standards of Excellence.