https://amzn.to/44P6GXZ
The Revenue Integrity Director is a pivotal role responsible for overseeing and optimizing the revenue cycle processes while ensuring compliance with regulations, maximizing revenue capture, and maintaining integrity within the revenue streams. This position requires a combination of strong managerial skills, in-depth knowledge of revenue cycle management, and a keen understanding of healthcare billing and coding regulations.
ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES
Monitor and optimize billing, coding, and collections processes to minimize denials and maximize revenue realization.
Develop and maintain revenue integrity programs and revenue cycle strategies to ensure accurate billing and coding practices in compliance with regulatory requirements as well as enhance efficiency and financial performance.
Analyze data and metrics to identify trends, inefficiencies, and opportunities for improvement within the revenue cycle.
Conduct regular audits and reviews to identify and rectify potential compliance risks or revenue leakage. Use this information to collaborate with coding and compliance to address discrepancies and implement corrective actions.
Negotiate contracts with vendors and service providers, seeking cost-effective solutions and ensuring alignment with organizational benefits.
Oversee the RCM team (billing, collections, cash posting)
Lead the revenue recognition process for month-end and year-end closures, ensuring accuracy and compliance with accounting standards.
Collaborate with finance and accounting teams to reconcile revenue figures and address discrepancies promptly.
Participate in due diligence processes for acquisitions, assessing revenue cycle implications, risks, and opportunities.
Partner with Intake, Authorization, and Eligibility Director to optimize patient intake processes and ensure accurate eligbility verification, minimizing revenue cycle bottlenecks.
Develop and oversee cash flow forecasting models based on revenue projections and payer trends, ensuring financial stability and liquidity.
Design and implement a comprehensive KPI reporting dashboard to monitor key revenue cycle metrics, providing actionable insights for performance improvement.
Assess and reconfigure talent and organizational structures within the revenue cycle team to optimize efficiency and align with strategic objections.
Manage relationships with external outsourced vendors, ensuring service levels, contractual compliance, and cost-effectiveness in revenue cycle operations.
Actively participate in senior leadership meetings including contributing to Management Operating Reviews (MORs) and board reporting, presenting revenue cycle performance metrics, challenges, and strategic initiatives.
Stay abreast of all regulatory changes and announcements impacting revenue cycle operations, ensuring timely adaptation and compliance.
Foster a culture of continuous improvement, encouraging innovation and best practices in revenue cycle operations while leading and mentoring a team, providing guidance, and support in achieving departmental goals.
Develop and implement policies and procedures to maintain compliance with healthcare laws and regulations.
Serve as a liaison between departments to facilitate communication and alignment of revenue cycle objectives. This includes collaborating with finance, IT, clinical departments, and other stakeholders to streamline revenue cycle processes and address operational challenges.
Establish quality assurance protocols revenue cycle processes and providing targeted training to address gaps and improve accuracy.
Oversee the resolution of billing disputes and manage the appeals process for denied or underpaid claims, maximizing revenue recovery.
Other duties as assigned by the Chief Financial Officer,
POSITION QUALIFICATIONS
1 Two years of college preferred
2.One-year experience at Administrative level in general office surrounding; One-year experience in healthcare setting.
3.Working knowledge of medical terminology
4.Ability to type 50 WPM; 10-key by touch
5.In-depth knowledge of healthcare billing, coding, reimbursement methodologies, and regulatory compliance (e.g. HIPAA, CMS guidelines)
6.Strong leadership and managerial skills with the ability to motivate and guide teams effectively
7.Proficiency in data analysis and utilization of revenue cycle management software and tools.
SKILLS REQUIRED
1.Excellent computer skills required excellent interpersonal and organizational skill
2.Prolonged sitting and some standing required. Occasional need to lift, pull, carry, and push items weighing up to 50 pounds. Frequent need to stop, kneel, and reach while accessing files. Requires working under some stressful conditions to meet deadlines and staff/patient needs. Requires hand-eye coordination and manual dexterity.
Maintenance Specialist – 2nd Shift page is loaded Maintenance Specialist – 2nd Shift Apply locations Hanover, NH time type Full...
Apply For This JobIntroduction Medical City Healthcare is committed to investing in the latest technology enabling nurses to work more efficiently.Are you passionate...
Apply For This JobReports to: Brand (Store) Manager Location: On-Site Store Location Do you love encouraging others to achieve their goals? Do you...
Apply For This JobJob Title: Human Resources Generalist Location: Jefferson, WI Hours: Monday-Friday 8:00 am – 4:30 pm St. Coletta of Wisconsin, a...
Apply For This Jobjelli is delighted to be working with a rapidly growing global organisation whose purpose is to drive behavioural and cultural...
Apply For This JobProject Overview: Intellias is a leading software engineering company with more than 20 years on the market providing end-to-end software...
Apply For This Job