Associate Director, Compliance, Revenue Integrity

This is a fully remote position, open to applicants in United States.

📋 Description

• Ensure the accuracy of revenues collected and billed throughout all health system entities.

• Review and guarantee precise charging and strategic pricing methodologies.

• Employ denial prevention strategies and supervise compliant revenue management practices.

• Investigate regulatory documentation to maintain compliance with revenue integrity.

• Uphold staff adherence to Cedars-Sinai policies, procedures, and protocols.

• Keep track of productivity and quality targets and benchmarks.

• Coordinate subject matter expertise across responsibilities and serve as a liaison between Revenue Cycle, Finance, and clinical departments.

• Strategically plan, organize, and execute process and business enhancements for initiatives.

• Collaborate with inter-departmental teams to effectuate cohesive changes.

• Develop, sustain, and improve the Charge Description Master (CDM) in accordance with policies and the annual compliance plan.

• Create denial avoidance feedback loops and refine operational processes to boost revenue capture.

• Engage in or lead workgroups and committees focused on revenue optimization and denial reduction.

• Suggest enhancements and initiatives that promote optimal revenue capture.

• Evaluate charge-master services and codes, charge capture, and compliance audits to ensure adherence to compliant charging practices.

⛳️ Requirements

• A Bachelor's degree in business administration, health, or a related field is required.

• A minimum of 5 years of progressive experience in healthcare is necessary.

• EPIC Certifications in Hospital Billing (HB) and Professional Billing (PB) are preferred.

• A Coding or Compliance Certificate (AHIMA, AAPC, HCCA) is preferred.

• Familiarity with healthcare Revenue Cycle trends and regulatory matters is essential.

• Understanding of state and federal laws, accreditation, professional standards, and licensing requirements is necessary.

• Knowledge of compliant charging practices, charge-master services and codes, charge capture, and compliance audits is required.

🏝️ Benefits

• Health care.

• Paid time off.

• 403(b) plan.

• Health and dental insurance.

• Vacation time.

• A dynamic, inclusive work environment.

• An employee engagement-focused workplace.