As the Director of Revenue Integrity, you will be responsible for ensuring appropriate oversight and implementation of revenue integrity policies and procedures.
You will oversee the daily charge reconciliation and capture, compliant charging, coding and documentation, and the performance of routine audits to ensure that system interfaces are working properly. You will oversee the hiring, orientation and development of new employees, assign work and conduct performance evaluations for employees.
- Oversees the maintenance of on-line and manual charge masters; ensures that electronic charge entry systems and manual charge slips are up-to-date and compliant with Medicare and Medi-Cal regulations.
- Defines and meets revenue cycle performance goals and metrics. Evaluates the performance and effectiveness of management and staff related to the revenue cycle metrics and works to continuously improve performance, outcomes and maximize.
- Develops daily reconciliation reports that assist managers in maintaining accurate and timely charges. Ensures that a process is in place that reconciles charges back to the daily ancillary and clinic patient schedules.
- Develops supports and maintains charge capture and entry systems and processes for all points of revenue capture at Alameda Health System to ensure that all charges and codes are reconciled daily and meet system charge lag targets; keeps abreast of payer and billing, collection and general coding requirements; applies knowledge to ensure that charges are accurate, billed correctly and supportable according to payor requirements.
- Performs daily audits to ensure that the general ledger balances with charge entry system interfaces, charge transaction errors are resolved and any charging irregularities are reported back to the manager for resolution.
- Performs special research, assists in the development of new charge capture policies and procedures, and implements charge capture process improvements.
- Supervises charge entry supervisors, specialists and information systems analysts. Hires and trains new employees, assigns work, disciplines and counsels work related performance issues and responsible for managing staff against workload goals and standards of performance.
- Trains managers on proper documentation of charges and the assignment of rendering providers. Works with managers and providers to ensure proper selection of charges based on the type and location of services provided.
Education: Bachelor’s Degree in Finance, Business Administration or related field from a recognized college or university is required.
Experience: Seven years’ experience working in a business office or revenue capture department within a hospital or health system required. At least five years in a supervisory/people management capacity.