Director of Revenue Integrity and HIM

Cheyenne Regional Medical Center•Cheyenne, WY

28d

About The Position

The Director of Revenue Integrity and Health Information Management (HIM) is an analytical leader responsible for overseeing facility and professional coding, clinical documentation improvement (CDI), and HIM operations. The Director is the Custodian of Record and provides oversight to the Release of Information (ROI) vendor relationship. This position plays a crucial role in cross-departmental collaboration, working closely with clinical, financial, and operational leaders while driving continuous improvement and enhancing operational efficiency.

Requirements

Bachelor's degree or higher
Seven (7) or more years of experience in Health Information Management
Two (2) or more years of leadership experience
Certification (must meet one of the following):
Current Registered Health Information Administrator (RHIA) certification from the American Health Information Management Association (AHIMA)
Current Registered Health Information Technician (RHIT) certification from AHIMA
Current Certified Coding Specialist (CCS) certification from AHIMA
Current Certified Professional Coder (CPC) certification from the American Academy of Professional Coders (AAPC)
Current Certified Inpatient Coder (CIC) certification from AAPC
Current Revenue Cycle Management Specialist (RCMS) certification from AAPC
Working knowledge of functional HIM areas
Knowledge of compilation, and storage of the medical record for all patient and administrative services
Knowledge of established coding guidelines and regulations, CDI operations, and trauma registry
Ability to analyze data, draws conclusions, and makes recommendations
Ability to develop policies and procedures, facilitate reviews of, initiate process improvement initiatives
Ability to review complex processes and understand the interdependence and interactions/interventions necessary at the various stages in the process
Ability to work independently
Technical knowledge of processes using AI

Nice To Haves

Ten (10) or more years of HIM experience
Lean management experience
RHIA or RHIT certification

Responsibilities

Provides strategic direction and operational oversight for HIM, CDI, coding, and Revenue Integrity functions.
Lead and develop high-performing teams across facility/professional coding, CDI, and HIM while facilitating communication and alignment between departments to support revenue integrity functions.
Collaborates with clinical, financial, and IT stakeholders to align documentation and coding practices with regulatory and reimbursement requirements. Collaborate with IT and data governance teams to ensure data quality and security.
Maintain current knowledge of coding, documentation, reimbursement, and HIM regulations and standards and identifies opportunities for improvement.
Oversee Coding and CDI initiatives to improve provider documentation and clinical data quality. Reviews CDI performance, productivity and quality with the manager. Monitor and analyze trends to identify opportunities for improvement.
Direct HIM operations including record management, retention, compliance, and data governance. Delegates or certifies records and supervises all inspections, copying or duplication or records in prescribed timelines while adherence to federal and state regulations including HIPAA and other privacy laws and oversight on vendor relationship for ROI services, ensuring performance standards and compliance.
Lead efforts to review and maintain the organizational charge master in collaboration with clinical, financial, compliance, and Epic departments.
Ensure charge descriptions, coding, and pricing are accurate, compliant, and aligned with payer requirements. Oversee the integrity, accessibility, and utilization for clinical and financial analysis.
Conduct department and organizational audits and reviews to ensure accuracy and identify reporting and training needs to departments and leadership.
Develop, implement, and review policies and procedures to ensure compliance and operational excellence.
Testifies to the admissibility of records and may be asked to verify the timeliness and normal business practices used to develop and maintain health records.
Champions Lean fundamentals to drive continuous improvement, eliminate waste, and enhance operational efficiency across all areas of responsibility.
Encourages and supports employee growth through AAPC, AHIMA, MGMA, and HFMA and other healthcare and finance related sources.
Works collaboratively with the Revenue Integrity Medical Director and the Revenue Cycle Administrator.