Associate Director, Revenue Integrity

Banner Health•Phoenix, AZ

3d•$37 - $62•Remote

About The Position

Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Banner Health the best place to work and receive care. As an Associate Director of Revenue Integrity you will be an integral part of leadership within the team. During your typical duties, you will have the opportunity to educate and develop team members, roll out process changes and projects, as well as troubleshooting questions from your team and outside stakeholders, and conducting review of findings. This position, under the direction of the Revenue Integrity Director, will provide operational oversight of the Revenue Integrity Analyst team. Responsibilities include revenue optimization through implementing standard charge capture reconciliation, charge capture review initiatives, charge capture education and process to ensure charge capture integrity and revenue optimization in compliance with CMS and other regulatory agencies.

Requirements

Bachelors degree in business, healthcare administration or equivalent work experience
5+ years recent experience in Revenue Integrity (clearly reflected in your attached resume)
At least 2 years of experience within leadership role, including performance management of direct reports.
Must possess a strong knowledge of business and/or healthcare as normally obtained through the completion of a bachelor’s degree in business, health care administration or previous work experience.
Requires proficiency typically obtained with five or more years of health care coding and billing experience.
Must possess a thorough knowledge of ICD/DRG coding and/or CPT coding principles, and the recommended American Health Information Management Association coding competencies.
Requires an in-depth knowledge of medical terminology, anatomy and physiology, plus a thorough understanding of the content of the clinical record and an extensive knowledge of all coding conventions and reimbursement guidelines, across all services lines, LCD/NCDs and MAC/FIs.
Extensive critical and analytical thinking skills required.
Ability to organize workload to meet deadlines and maintain confidentiality of all work information.
Ability to research, interpret and develop recommendations.
Excellent written and oral communication skills are required, as well as effective human relations and leadership skills for building and maintaining a working relationship with all levels of staff, physicians, and other contacts.

Nice To Haves

In the acute care environment, may require a Registered Health Information Administrator (RHIA), Registered Health Information Technologist (RHIT) or Certified Coding Specialist (CCS) in an active status with American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC), or relevant work experience. In the ambulatory setting, requires Certified Professional Coder (CPC) certification or Certified Coding Specialist-Physician (CCS-P), with RHIA, RHIT or CCS, or relevant work experience.
Additional related education and/or experience preferred.

Responsibilities

Monitors and trends financial data related to charge capture progress toward revenue cycle goals, identifies variances and implements process improvement as necessary to enhance compliant revenue optimization.
Provide operational oversight of the revenue integrity staff and serve as a liaison between Revenue Integrity and clinical/operational departments to escalate charge issues and inquiries to key stakeholders. Supports finance, operations, and revenue cycle teams through special projects.
Develop, educate and manage Revenue Integrity Specialists, supporting them in analyzing, communicating and educating hospital and clinics regarding deficient charging trends and corrective action plans to resolve deficiencies.
Engage with clinical areas and revenue cycle departments across Banner to confirm billable items and services are charged appropriately and in a timely manner.
Provide revenue integrity recommendations and updates to the Revenue Integrity Steering Committee with potential actions for remediation. Upon resolution and approval of recommendations confirm appropriate actions are carried out accurately and completely.
Maintains current knowledge of regulatory changes impacting charge practices. Develops charge capture and reconciliation policy and procedures. Monitor/report monthly KPI Revenue integrity metrics dashboard.
Implement charge capture review program for hospital revenue generating departments. Coordinates processes between operations and revenue cycle departments ensuring that the accounts reviewed reflect proper documentation, charge capture, coding and billing to support proper payment.
Manages charge reviews to ensure annual coding changes/new service lines incorporated into charge master flow correctly to the patient bill. Purpose of these special projects are department specific and the goal is to identify potential compliance issues and revenue leakage issues.
Works independently under limited supervision. Makes independent judgments based on specialized knowledge. Holds system-wide responsibility for managing the company’s charge capture, charge reconciliation and chart reviews related to charging issues. Internal customers: company leadership, company’s compliance committees, revenue cycle team, physicians and clinical staff.