Director of Revenue Integrity

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

📋 Description

• Direct revenue integrity operations at the TGH Cancer Institute, encompassing charge capture, reconciliation, and coding methodologies.

• Develop and supervise workflows to detect and rectify missing, inaccurate, duplicate, or delayed charges prior to the submission of claims.

• Manage coding quality and timelines while collaborating with providers and clinical leaders to enhance documentation that supports accurate and compliant billing.

• Evaluate charge, coding, billing, and denial data; determine root causes and spearhead changes to avert recurring errors and denials.

• Collaborate with Revenue Cycle, Clinical Operations, Patient Access, Compliance, IT, and Epic teams to outline business requirements, test modifications, and validate workflow and system updates.

• Set performance metrics for charge capture, reconciliation, coding accuracy, clean claims, and preventable denials; communicate findings and suggested actions to leadership.

• Guide and cultivate assigned revenue integrity and coding personnel, including establishing expectations, assessing performance, and addressing performance gaps.

• Ensure revenue integrity practices comply with relevant billing regulations, payer specifications, and organizational policies.

⛳️ Requirements

• Bachelor's degree in Healthcare Administration, Finance, Business, Health Information Management, or a related discipline.

• At least 7 years of experience in revenue integrity with progressively responsible roles within a complex healthcare environment.

• A minimum of 3 years in a leadership capacity.

• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Revenue Cycle Representative (CRCR), or a similar certification.

• Proficient understanding of professional billing, coding, charge capture, and revenue cycle processes.

• Capability to analyze charge, billing, and denial data to ascertain the root causes of revenue leakage.

• Proficient in leading initiatives that involve access, clinical, operational, IT, and Revenue Cycle teams.

• Experience with Epic Resolute, including HB/PB billing workflows, charge router, charge reconciliation, and charge review.

🏝️ Benefits

• Comprehensive health benefits package.

• Professional development and continuing education opportunities.

• Collaborative and supportive work environment.

• Competitive compensation and performance-based incentives.