Northern Arizona Healthcare ยท 5 hours ago
System Director of Revenue Integrity
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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
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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