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Director of Revenue Integrity
Remote, RemoteAs the Revenue Integrity Director, your role will define and carry out the strategy for maximizing gross and net revenue capture across all departments. The Director serves as the chief liaison between Revenue Cycle, clinical operations, sales operations, customer success and the IT departments. The Director also ensures the availability and interpretation of reporting and analytics necessary for the Revenue Cycle department to drive financial improvement.
Within the Revenue Integrity department, the Director monitors the following functions: charge capture, revenue reconciliation, billing system maintenance, contract management, payment validation, denial management and avoidable write-off prevention, and reporting and analytics. They also serve as the ultimate escalation point for both the gross and net revenue streams. While Revenue Cycle is not formally under the supervision of the Revenue Integrity Director, it will be the Directors job to collaborate with the Revenue Cycle team and ensure teamwork and knowledge share across teams to avoid any duplicative or conflicting efforts. The Director will report directly to the EVP of Revenue Cycle.
Job Responsibilities:
Job Qualifications:
The estimated hiring salary range for this position is $120,000 to $130,000.* The actual salary will be based on a variety of job-related factors, including geography, skills, education and experience. The range is a good faith estimate and may be modified in the future. This role is also eligible for a range of benefits including medical, dental and 401Kretirement plan.
Within the Revenue Integrity department, the Director monitors the following functions: charge capture, revenue reconciliation, billing system maintenance, contract management, payment validation, denial management and avoidable write-off prevention, and reporting and analytics. They also serve as the ultimate escalation point for both the gross and net revenue streams. While Revenue Cycle is not formally under the supervision of the Revenue Integrity Director, it will be the Directors job to collaborate with the Revenue Cycle team and ensure teamwork and knowledge share across teams to avoid any duplicative or conflicting efforts. The Director will report directly to the EVP of Revenue Cycle.
Job Responsibilities:
- Develop, coordinate, implement, and oversee the all Revenue Cycle projects including developing requirements and collaborating with all stakeholders to ensure alignment across all impacted areas,
- Ensure the effectiveness of the revenue integrity program, including overall consistency and integration of integrity activities throughout the organization
- Support all departments related to new revenue initiatives, such as being the subject matter expert in the development of new initiatives.
- Ensure the alignment of the revenue integrity program with applicable policies and procedures and all applicable laws, standards, and regulations
- Review, revise, and develop policies for adoption via institutional processes, as appropriate, to complement and reinforce the revenue integrity program
- Create and chair the revenue integrity committee
- Work closely with executive management to ensure that the revenue integrity program meets applicable financial, operational, and legal requirements
- Provide periodic reports to executive leadership regarding the nature, progress, and status of the revenue integrity program, any corrective action being taken, and any recommended changes
Job Qualifications:
- Bachelor's Degree in Business Administration, Health Care Administration, Clinical Administration, Finance, and/or related afield required.
- Eight years of Revenue Cycle, Revenue Integrity, and/or reimbursement experience are required, including seven years management experience, with emphasis on project management.
- Knowledge of Revenue Cycle processes, medical billing and coding processes, quantitative decision making, and process analysis.
- Strong interpersonal skills, critical thinking skills, and the ability to communicate effectively to secure clinical and non-clinical information required for technical and operational revenue updates.
- Ability to work independently and take initiative across multiple workstreams.
- Skill in time management and project management, and multi-tasking is a must for this position.
- Ability to apply appropriate supervisory, management, and leadership techniques in an operational setting.
- Advanced level of communication, problem solving, and organizational skills to maintain a high level of production and accuracy in an extremely task driven environment.
- Demonstrated expertise using Access, Excel, PowerPoint, and Word. Basic knowledge of SQL.
- Use of machine learning and AI technologies to build predictive models, automate tasks and find patterns in data.
- Ability to express ideas and communicate professionally, effectively, verbally and in writing, and to train others on technical matters.
- Excellent ability to understand and interpret statistical reports and perform quantitative analysis.
- Advanced skills in problem solving in a variety of settings and translation of data into actionable steps.
- Strong knowledge of insurance claim processing and third-party reimbursement.
- Knowledge of state and federal regulations as they pertain to billing processes and procedures.
The estimated hiring salary range for this position is $120,000 to $130,000.* The actual salary will be based on a variety of job-related factors, including geography, skills, education and experience. The range is a good faith estimate and may be modified in the future. This role is also eligible for a range of benefits including medical, dental and 401Kretirement plan.