Associate Director Revenue Integrity

About This Role

This role will provide operational oversight of the Revenue Integrity Analyst team, focusing on revenue optimization through charge capture reconciliation, review initiatives, education, and process to ensure integrity and compliance with regulatory agencies.

Responsibilities

• Monitor and trend financial data related to charge capture progress toward revenue cycle goals, identify variances and implement process improvement to enhance compliant revenue optimization
• Provide operational oversight of the revenue integrity staff and serve as a liaison between Revenue Integrity and clinical/operational departments to escalate charge issues and inquiries to key stakeholders
• Support finance, operations, and revenue cycle teams through special projects
• Develop, educate and manage Revenue Integrity Specialists, supporting them in analyzing, communicating and educating hospital and clinics regarding deficient charging trends and corrective action plans
• Engage with clinical areas and revenue cycle departments across Banner to confirm billable items and services are charged appropriately and in a timely manner
• Provide revenue integrity recommendations and updates to the Revenue Integrity Steering Committee with potential actions for remediation
• Maintain current knowledge of regulatory changes impacting charge practices and develop charge capture and reconciliation policy and procedures
• Monitor/report monthly KPI Revenue integrity metrics dashboard
• Implement charge capture review program for hospital revenue generating departments
• Manage charge reviews to ensure annual coding changes/new service lines are incorporated into charge master and flow correctly to the patient bill

Requirements

• 5+ years recent experience in Revenue Integrity
• At least 2 years of experience within leadership role, including performance management of direct reports
• Strong knowledge of business and/or healthcare
• Thorough knowledge of ICD/DRG coding and/or CPT coding principles
• In-depth knowledge of medical terminology, anatomy and physiology
• Thorough understanding of the content of the clinical record
• Extensive knowledge of all coding conventions and reimbursement guidelines, across all services lines, LCD/NCDs and MAC/FIs
• Extensive critical and analytical thinking skills

Qualifications

• Bachelor's degree in business, healthcare administration or equivalent work experience
• 5+ years of health care coding and billing experience, with at least 2 years in a leadership role

Nice to Have

• Additional related education and/or experience

Benefits

Certifications