Associate Director Revenue Integrity

About This Role

This position provides operational oversight of the Revenue Integrity Analyst team, focusing on revenue optimization through charge capture initiatives and education. The role ensures charge capture integrity and compliance with CMS and other regulatory agencies.

Responsibilities

• Monitor and trend financial data related to charge capture progress toward revenue cycle goals, identify variances and implement process improvement
• Provide operational oversight of the revenue integrity staff and serve as a liaison between Revenue Integrity and clinical/operational departments
• Develop, educate and manage Revenue Integrity Specialists, supporting them in analyzing, communicating and educating hospital and clinics
• 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
• Maintain current knowledge of regulatory changes impacting charge practices
• Develop charge capture and reconciliation policy and procedures
• Implement charge capture review program for hospital revenue generating departments
• Manage charge reviews to ensure annual coding changes/new service lines incorporated into charge master 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
• Thorough 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 and reimbursement guidelines

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