Director, Revenue Integrity
- San Leandro, CA
- Revenue Integrity
- Full Time - Day
- Req #: 26103-17229
- Posted: March 4, 2020
SUMMARY: The Director, Revenue Integrity is responsible for ensuring appropriate oversight and implementation of revenue integrity policies and procedures that include overseeing daily charge reconciliation and capture, compliant charging, coding and documentation, and the performance of routine audits to ensure that system interfaces are working properly. Supervision includes selection of new employees, training and orientation, workload assignment and completion of performance evaluations for employees. Performs related duties as required.
DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in this
classification. However, employees may perform other related duties at an equivalent level. Not all duties listed are
necessarily performed by each individual in the classification.
1. Oversees the maintenance of on-line and manual charge masters; ensures that electronic charge entry systems and manual charge slips are up-to-date and compliant with Medicare and Medi-Cal regulations.
2. Defines and meets revenue cycle performance goals and metrics. Evaluates the performance and effectiveness of management and staff related to the revenue cycle metrics and works to continuously improve performance, outcomes and maximize.
3. Develops daily reconciliation reports that assist managers in maintaining accurate and timely charges. Ensures that a process is in place that reconciles charges back to the daily ancillary and clinic patient schedules.
4. Develops supports and maintains charge capture and entry systems and processes for all points of revenue capture at Alameda Health System to ensure that all charges and codes are reconciled daily and meet system charge lag targets; keeps abreast of payer and billing, collection and general coding requirements; applies knowledge to ensure that charges are accurate, billed correctly and supportable according to payor requirements.
5. Performs daily audits to ensure that the general ledger balances with charge entry system interfaces, charge transaction errors are resolved and any charging irregularities are reported back to the manager for resolution.
6. Performs special research, assists in the development of new charge capture policies and procedures, and implements charge capture process improvements.
7. Supervises charge entry supervisors, specialists and information systems analysts. Hires and trains new employees, assigns work, disciplines and counsels work related performance issues and responsible for managing staff against workload goals and standards of performance.
8. Trains managers on proper documentation of charges and the assignment of rendering providers. Works with managers and providers to ensure proper selection of charges based on the type and location of services provided.
Education: Bachelor’s Degree in Finance, Business Administration or related field from a recognized college or university required.
Minimum Experience: Seven years experience working in a business office or revenue capture department within a hospital or health system required.
Minimum Experience: Five years in a supervisory/people management capacity.