taleo
Director System Revenue Integrity
Cape Cod Healthcare
Remote, USA
Full-time
Senior · 5+ years experience
Remote
USD 145000-180000 yearly / year
Discovered Today
Free
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- Lead the establishment and implementation of Key Performance Indicators (“KPIs”) for revenue integrity functions; ensure the implementation of action plans where performance is not meeting expectations; review KPI expectations annually and adjust appropriately; recognize areas of excellence.
- Develop, implement, and oversee effective and consistent operational policies, processes, tools, and educational materials within all Revenue Integrity functional areas.
- Oversee the operational performance of a system-wide, service line-based Charge Review program dedicated to identifying charge capture issues/improvement opportunities to minimize revenue leakage, through the use of technology enablers and proactive internal audits/reviews of charging practices.
- Ensure that the CDM is compliant with regulatory and payer requirements and that all services provided have an established charging and reconciliation methodology.
- Ensure Revenue Integrity employees across all functions comply with established policies, processes, and quality assurance programs.
- Identify potential process improvements in charge capture functions, and lead the design and implementation as required.
- Monitor and facilitate service level agreements (“SLAs”) between Revenue Integrity operations and other related functions within both Revenue Cycle and Clinical operations. This includes confirmation that charge review queues/ requests are managed appropriately.
- Build strong relationships and facilitate productive communication between key Revenue Cycle stakeholders, including peer leaders of Revenue Cycle services and core support departments (e.g., human resources, IT, finance).
- Develop, implement, and manage efficient and effective operational policies, procedures, processes and performance monitoring across all revenue integrity functions.
- Ensure audit of denial management processes occurs consistently and coordinate with peers across the revenue cycle organization, and with other related stakeholders, to identify trends and implement denial prevention/recovery programs.
- Oversee, measure, and report ongoing financial and operational performance of Revenue Integrity, audit and appeals outcomes and denial management across CCHC.
- Support CCHC strategic initiatives that require involvement from revenue integrity functions as required.
- Assess direct reports’ performance on a consistent basis and provide feedback to reward effective performance and enable proactive performance improvement steps to be taken.
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