Associate Director Revenue Integrity

About This Role

This role will provide operational oversight to the Revenue Integrity Analyst team, focusing on revenue optimization through charge capture reconciliation, review, education, and process improvements. The Associate Director ensures compliance with CMS and other regulatory agencies while managing staff and engaging with clinical and operational departments.

Responsibilities

• Monitor and trend financial data related to charge capture progress, identify variances, and implement process improvements for revenue optimization.
• Provide operational oversight of revenue integrity staff and serve as a liaison between Revenue Integrity and clinical/operational departments.
• Develop, educate, and manage Revenue Integrity Specialists, supporting analysis and communication of deficient charging trends.
• Engage with clinical areas and revenue cycle departments to confirm appropriate and timely charging of billable items and services.
• Provide revenue integrity recommendations and updates to the Revenue Integrity Steering Committee, ensuring appropriate actions are carried out.
• Maintain current knowledge of regulatory changes impacting charge practices and develop charge capture and reconciliation policies and procedures.
• Implement charge capture review programs for hospital revenue-generating departments.
• Manage charge reviews to incorporate annual coding changes/new service lines into the charge master.
• Holds system-wide responsibility for managing the company’s charge capture, charge reconciliation and chart reviews related to charging issues.

Requirements

• Bachelor's degree in business, healthcare administration or equivalent work experience
• 5+ years recent experience in Revenue Integrity
• 2+ years of experience within leadership role, including performance management of direct reports
• Strong knowledge of ICD/DRG coding and/or CPT coding principles
• In-depth knowledge of medical terminology, anatomy and physiology
• Thorough understanding of clinical record content and coding conventions/reimbursement guidelines

Qualifications

• Bachelor's degree in business, healthcare administration or equivalent work experience
• 5+ years recent experience in Revenue Integrity; 2+ years in a leadership role with performance management of direct reports; 5+ years of health care coding and billing experience.

Nice to Have

• Additional related education and/or experience

Benefits

Certifications