Director of Revenue Integrity

About the role

The Director of Revenue Integrity will oversee the accuracy and integrity of revenue across all entities of the health network. Key responsibilities include:

• Review and assure accurate charging
• Strategic price setting
• Denial avoidance techniques
• Oversight of a training team
• Coordination and subject matter expertise across areas of responsibility
• Act as a liaison between Revenue Cycle and other departments
• Plan, organize, and implement process and business improvements
• Collaborate with inter-departmental teams to effect change

Responsibilities

Track and benchmark revenue integrity metrics for all departments while coordinating standard usage of all system reporting. Ensure optimization of the Epic System. Plan and implement regular reviews as directed by the Vice President of Revenue Cycle. Lead and direct the Revenue Cycle training teams to support all revenue cycle training needs and system wide training as necessary. Provide for effective chart audit policy with action plans and measurable outcomes. Ensure compliant charging through consistent review of chargemaster services and codes throughout the health network service lines. Manage RAC processes and workflows throughout the health network. Establishes denial avoidance feedback loops and improves operational processes to enhance revenue capture. Develops and makes recommendations in the creation of capital and operating budgets. Develops and strengthens relationships with medical staff and medical center entities. Makes recommendations to the Vice President of Revenue Cycle regarding programs, projects, or procedures that may improve efficiency, increase cash collections, reduce bad debt, motivate staff, or in general benefit the Revenue Cycle departments. Identifies and implements Transformational Healthcare projects to implement change rapidly and effectively. Ensures standard work is documented and implemented. Establishes effective communication with all departments impacting revenue including HIM, Information Systems departments, and revenue producing departments to ensure cohesive process among all areas impacting Revenue Cycle. Monitors and implements initiatives to improve patient experience and first impression scores.

Requirements

• College-level knowledge of the English language, including reading, writing, and speaking English
• Bachelor’s degree required. Successful experience in a similar role may be substituted for Bachelors
• Masters degree in business, accounting or finance with a Healthcare concentration preferred
• Five + years experience directly/indirectly managing a minimum of 75+ FTEs across multiple departments
• Five years of experience using PC spreadsheet applications