Director, Revenue Integrity
Company: Acuity Search Solutions, Inc.
Location: Decatur
Posted on: January 23, 2023
|
|
Job Description:
(Only QUALIFIED Healthcare Professionals accepted)
Hospital/Clinic Revenue Cycling - Director of Revenue Integrity
Needed
This hospital is located in Central IL near St. Louis, MO.
For more information, Contact David Lutz at 513-206-9881 and-or
email resume to: DLutz@AcuityMRI.com
Summary
The Director of Revenue Integrity is responsible for developing
standards and ensuring the integrity of the integrated acute care
revenue charge capture. This responsibility includes all aspects of
the Charge Description Master and fee schedule formulation(s),
review and maintenance to optimize revenue generation, and maintain
compliance with third party payer requirements; charge entry and
reconciliation; collaboration with all service lines across DMH;
policies and procedures development, modification and maintenance.
The Director of Revenue Integrity also is responsible for
developing a charge audit-capture-reconciliation process and
ensuring charges are maximized for reimbursement; provides
oversight and response for governmental audits such as RAC, MIC,
and Third Party Payor audits; participates in compliance related
activities and denials root cause and process improvement.
Essential Functions and Job Duties
1.Ensures compliance with required governmental laws, regulations,
contractual requirements, standards and practices both related to
the systems charge master.
2.Keeps abreast of changing industry requirements and regulations
regarding acceptable documentation and billing practices by
reviewing Federal Register, fraud alerts, OIG advisory opinions and
other relevant publications. Communicates changes to impacted
leaders and provides education on such changes.
3.Develops, assesses, and adapts clear and effective charge capture
process, policies and procedures, training, communications and
awareness material from a revenue integrity perspective.
4.Investigates and advises on matters relating to technical
billing, coding, or regulatory requirements for documenting,
coding, and billing.
5.Monitors and analyzes charge capture trends.
6.Assess auditing and monitoring trends and coordinate mitigation
activities when opportunities for improvement (audit variances) are
identified.
7.Maintain an awareness of current laws, statutes, regulations,
etc. that impact healthcare operations and physician
relationships.
8.Works with leaders across the organization to identify
opportunities to capture all charges efficiently.
9.Leads the effort to maintain the systems fee schedule.
Qualifications
To perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements listed
below are representative of the knowledge, skill, and-or ability
required.
Required Education
Bachelor's degree in nursing, business administration, finance
computer science or related field.
Preferred Education
Master's degree in business, health administration or related
field.
Required Experience
Knowledge of the content, structure and maintenance of the Charge
master and fee schedule.
Possess strong understanding of various reimbursement methodologies
with expert knowledge of all payer billing requirements in both the
facility and physician environments.
Proficient with Microsoft applications
Excellent written and verbal communication skills
Advanced problem-solving skills
Strong analytical skills capable of synthesis of complex
information
5+ years of revenue cycle management, IT management or project
management experience in a complex organization.
Preferred Certification & Licensures
RN, BSN, CIC, CCS, CPC designations are highly desirable.
Certification in auditing and-or health care compliance
desirable
For more information, Contact David Lutz at 513-206-9881 and-or
email resume to: DLutz@AcuityMRI.com
Keywords: Acuity Search Solutions, Inc., Decatur , Director, Revenue Integrity, Executive , Decatur, Illinois
Click
here to apply!
|