The Transplant Charge Review Manager oversees and optimizes processes to accurately determine the applicability of services to the transplant cost report. This leader analyzes transplant cost data, closely tracks all associated revenue streams, and partners with Revenue Integrity and Compliance teams to ensure financial accuracy and prevent missed or lost revenue. The Team Leader ensures compliance with all relevant regulations including CMS, CPT/HCPCS, and UB Revenue Codes while also fostering education, cross-functional collaboration, and ongoing staff development to uphold the highest standards of revenue integrity for transplant services.
Qualifications
Education
- Bachelor’s degree in healthcare administration, Business Administration, Finance, Health Information Management, Nursing, Accounting, or related field.
- Seven (7+) years of experience in lieu of a degree.
- Master’s degree preferred.
Experience
- Minimum five (5) years of healthcare revenue cycle experience.
- Minimum three (3) years of leadership experience in Revenue Integrity, Charge Capture, Transplant Finance, Billing, Coding or related discipline.
- Experience with academic medical centers and transplant programs strongly preferred.
- Epic experience a must.
License/Certification/Registration
- Certified Healthcare Revenue Integrity (CHRI) preferred.
- Certified Professional Coder (CPC) preferred.
- Certified Coding Specialist (CCS) preferred.
- Certified Revenue Cycle Representative (CRCR) preferred.
- Registered Health Information Administrator (RHIA) preferred.
- Registered Health Information Technician (RHIT) preferred.
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