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Company

Northern Arizona Healthcare · 7 hours ago

System Director of Revenue Integrity

Flagstaff, AZ

Full-time

Remote

Director/Executive

5+ years exp

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Responsibilities

Oversees the charge capture team and system to promote accuracy and integrity

Development of policies and procedures for reconciling charges posted

Identify opportunities for charge capture improvement

Coordinates and oversees hospital audit processes

Champions and collaborates with acute and hospital outpatient designated areas, Managed Care, Finance, Compliance, and other revenue cycle stakeholders to identify revenue leakage, and monitor charge capture activities

Maintain/enhance system chargemaster structure to ensure charges accurately reflect services provided consistent with industry best practice

Review changes in pricing, CPT codes, HCPCS codes and revenue codes for compliance with billing guidelines.

Create and produce annual price adjustment policy and ensure effective roll out

Responsible for personnel issues, such as vacation, patient time off, and general time and attendance issues.

Provides educational support to the inpatient and outpatient coding team.

Implements corrective action plans based on trends identified by internal and external reviews and personnel issues.

Demonstrates leadership using written, oral and interpersonal communication skills to effectively guide the work of reporting team to accomplish the delivery of the mission and vision of NAH through technology.

Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility.

If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.

Completes all company mandatory modules and required job-specific training in the specified time frame.

Identify and track potential areas of lost revenue. Builds relationships with service line leaders and works collaboratively to suggest/implement new revenue opportunities and/or mitigate areas of lost revenues

Monitor Service Line charge reconciliation and proactively identify areas of concern

Perform monthly revenue reconciliation procedures

Work collaboratively with Fin Ops and Fin Plan on service line reconciliation/trends/solutions

Suggest/create/executes charge capture/charge reconciliation automation

Tracks trends in statistics and identifies areas of revenue concerns to budget

Work Collaboratively with Revenue Cycle leaders to monitors denial trends and root cause and provide feedback as appropriate to reduce denials

Works closely with leaders to ensure that the Revenue Integrity program meets applicable financial, operational, and legal requirements

Responsible for a compliant System Pricing Policy (Updated annually)

Responsible for a compliant Price Transparency Policy (Updated annually)

Maintain and analyze revenue to ensure compliance with revenue recognition

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Revenue Cycle ManagementHospital Finance OperationsCharge Capture ImprovementCDM MaintenanceCerner EHROracle EHRSorian EHRRevenue RecognitionHealthcare ComplianceRevenue Capture WorkflowCertified Coding Specialist (CCS)Certified Outpatient Coder (COC)Certified Procedural Hospital Coder (CPHC)Basic Computer Skills

Required

Bachelor's Degree in related field or Equivalent Experience with 5+ years of Hospital operations management

5 years Revenue Cycle management or Hospital Finance Operations

Revenue Capture Workflow Creation And Implementation Experience

Clinical health care setting revenue cycle experience, hospital preferred.

Understanding of computers, and competence in using computers and basic software programs.

Preferred

Bachelor's Degree or Equivalent in Accounting or Finance

2+ years Cerner/Oracle/Sorian EHR experience

At least one of the following is preferred: Certified Coding Specialist (CCS), Certified Outpatient Coder (COC), Certified Procedural Hospital Coder (CPHC), or desire to obtain within 1 year of hiring