Associate Director, Compliance & Revenue Integrity

Cedars-Sinai•United States,

8h•$138,299 - $239,262

About The Position

The Associate Director of Compliance and Revenue Integrity (CRI) is responsible for ensuring the integrity of revenues captured and billed across all entities of the health system. This includes accurate charging, strategic price setting, denial avoidance, and oversight of compliant revenue management practices in clinical and department operations. The role supports patient-focused revenue cycle operations and a metric-driven, performance-based culture of compliance and accountability. The Associate Director monitors healthcare revenue cycle trends and emerging regulatory issues, researches regulatory documentation, and ensures compliance with applicable laws, accreditation standards, agency requirements, licensure requirements, and health system policies. The role coordinates with Revenue Cycle, Finance, and clinical departments; leads strategic process and business improvements; and develops, maintains, and enhances the charge description master (CDM) in accordance with system policy and the annual compliance plan. It also promotes denial avoidance, revenue optimization, and compliant charging through operational feedback, charge-master review, and charge-capture and compliance audits.

Requirements

Bachelor's degree in business administration, health, or a related major.
At least 5 years of progressive healthcare experience.

Nice To Haves

Master's degree.
EPIC certifications in HB and PB.
Coding or compliance certificate from AHIMA, AAPC, or HCCA.

Responsibilities

Monitor healthcare revenue cycle trends and emerging regulatory issues, and research regulatory documentation to support revenue integrity compliance.
Ensure compliance with state and federal laws, accreditation standards, professional and regulatory agency standards, licensure requirements, and health system policies, procedures, and protocols.
Monitor productivity and quality goals and benchmarks, identify potential improvements, and advance compliant revenue management education, productivity, and best practices.
Coordinate subject matter expertise and act as a liaison among Cedars Sinai Revenue Cycle, Finance, and clinical departments to develop streamlined, cost-effective, provider- and patient-centric operations.
Plan, organize, and implement process and business improvements for designated strategic initiatives, collaborating with interdepartmental teams to effect cohesive change.
Develop, maintain, and enhance the charge description master (CDM) in compliance with health system policy and the annual compliance plan.
Establish denial-avoidance feedback loops and improve operational processes to enhance revenue capture.
Participate in or lead workgroups and committees supporting revenue optimization and denial mitigation initiatives and strategies.
Recommend improvements and initiatives that support optimal revenue capture.
Ensure compliant charging practices through consistent review of charge-master services and codes, charge capture, and compliance audits across the health system.