St Francis Medical Center

Director Revenue Integrity

St Francis Medical Center$108K — $130K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Master’s degree preferred, Bachelor’s degree required.
  • 10 years of experience in Finance or Revenue Cycle with 5 years in leadership roles.
  • Detailed knowledge of privacy and security regulations, confidentiality/HIPAA, and payer authorization requirements.
  • Working knowledge of Medical Terminology and Current Procedural Coding (CPT, HCPCS) as well as Diagnostic Coding (ICD-9, ICD-10).
  • Expertise with federal and state regulations and accreditation standards.
  • Demonstrated experience diagnosing and addressing operational issues.
  • Exceptional leadership and team-building skills.

Responsibilities

  • Lead the strategic and operational management of the Revenue Integrity department.
  • Ensure financial strength and compliance across Revenue Cycle operations.
  • Monitor and enhance the quality and accuracy of Revenue Integrity processes.
  • Oversee data integrity and reporting related to financial performance and improvement initiatives.
  • Establish and achieve net revenue/performance improvement goals.
  • Ensure the effectiveness of Revenue Integrity policies, practices, and technology platforms.

Benefits

  • Comprehensive, competitive benefits package allowing for customization to fit individual needs.
  • Abundant resources and programs to support individual growth and well-being.
Full Job Description
Responsibilities

The Director Revenue Integrity is responsible for strategic and operational leadership of the Revenue Integrity department.   This position contributes to the financial strength, compliance and overall performance of Revenue Cycle operations by providing leadership for all Revenue Integrity functions, including hospital and physician (provider) services.  The Director Revenue Integrity serves in a key role to monitor and facilitate improvement in the overall quality, timeliness, completeness, and accuracy of Revenue Integrity processes (such as charge master accuracy, charge compliance and accuracy, payment variance analytics and prevention and overall quality and accuracy of all data flowing through the revenue cycle).  Data integrity and reporting of financial performance and impact of improvement initiatives and standard KPIs is required.  The Director will ensure the effectiveness of Revenue Integrity policy, practices and technology platforms.  Net revenue/performance improvement goal setting, monitoring and achievement are required.  The Director Revenue Integrity reports directly to the Vice Presient of Revenue Cycle at Central Maine Healthcare.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

 

Education and Experience:

  • Master’s degree preferred, Bachelor’s degree required, and
  • Ten (10) years of experience in Finance or Revenue Cycle with a minimum of 5 years of experience in leadership roles.

 

Knowledge, Skills, and Abilities:

  • Detailed knowledge of privacy and security regulations, confidentiality / HIPAA, payer registration /authorization requirements, State Charity Care compliance, and MaineCare compliance regulations.
  • Working knowledge of Medical Terminology, Current Procedural Coding (CPT, HCPCS), Diagnostic Coding (ICD-9, ICD-10).
  • Expertise with regulations and accreditation standards, knowledge of specific state and federal requirements and standards.
  • Working knowledge of Medical Record, Financial Services and Healthcare Application technology.
  • Demonstrated experience in diagnosing, evaluating and developing corrective actions for problems in operations.
  • Able to effect collaborative alliances and promote teamwork.
  • Ability to ensure a high level of employee, patient, visitor, and external stakeholder satisfaction.
  • Effective organizational, planning, controlling, scheduling and project management abilities.
  • Effective managerial and administrative abilities as applied to the management of multiple projects.
  • Effective leadership abilities.
  • Financial acumen with ability to extract data, ensure integrity, produce reports and utilize for communicating results and affecting change.
  • Ability to positively influence change.
  • Excellent communications skills, both oral and written.
  • Demonstrated ability to work well with diverse people, excellent human relation skills.
  • Flexible and able to react to ever changing priorities.
Pay Transparency

Central Maine Healthcare Corporation offers competitive compensation and a reasonable compensation estimate for this role is $XX.XX to $XX.XX. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/

Employment StatusFull Time ShiftDays

About St Francis Medical Center

St. Francis Medical Center is a for-profit hospital in Lynwood, California, United States, owned by Prime Healthcare Services.
Learn more about St Francis Medical Center

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