Associate Director Revenue Integrity

About This Role

This Associate Director of Revenue Integrity position involves providing operational oversight to the Revenue Integrity Analyst team, educating and developing team members, and ensuring compliant revenue optimization through charge capture reconciliation and review initiatives in a healthcare setting.

Responsibilities

• Monitor and trend financial data related to charge capture progress toward revenue cycle goals
• Identify variances and implement process improvements to enhance compliant revenue optimization
• Provide operational oversight of the revenue integrity staff
• Serve as liaison between Revenue Integrity and clinical/operational departments to escalate charge issues and inquiries
• Develop, educate, and manage Revenue Integrity Specialists in analyzing, communicating and educating hospitals and clinics regarding deficient charging trends
• Engage with clinical areas and revenue cycle departments to confirm billable items and services are charged appropriately
• 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

Requirements

• 5+ years of health care coding and billing experience
• 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
• Extensive knowledge of all coding conventions and reimbursement guidelines across all service lines, LCD/NCDs and MAC/FIs

Qualifications

• Bachelor's degree in business, healthcare administration or equivalent work experience
• 5+ years recent experience in Revenue Integrity; at least 2 years of experience within a leadership role including performance management of direct reports.

Nice to Have

• Additional related education and/or experience

Benefits

Certifications