Executive Director- Revenue Integrity in Altamonte Springs, FL at Adventist Health System

Date Posted: 11/9/2018

Job Snapshot

  • Job Schedule
    Full-Time
  • Job Category
  • Date Posted:
    11/9/2018
  • Job ID:
    18014977
  • Job Function
    Accounting/Finance
  • Travel
    Yes, 75 % of the Time
  • Shift
    1 - Day
  • AHS Zone
    1-Shared Services
  • Organization
    Adventist Health System Corporate Office

Job Description


Description
Work Hours/Shift

Full Time

Adventist Health System Corporate Office

Be part of the Adventist Health System family.

Where you work matters. Working here is like being part of a family. Not just with those you serve, but also with your team members. It’s about making a difference, saving lives, and helping others live a fuller one. You’ll be joining a family of tens of thousands of team members who understand that what they do is bigger than healthcare. It is living out our mission to Extend the Healing Ministry of Christ and being there for someone every step of the way-body, mind, and spirit.

This is more than a career. It is a calling.

With hospitals and facilities in 9 states, you’ll have endless opportunities to take your talents, develop your skills, and grow as a professional in a place that truly cares about your success. If you are driven, compassionate, someone who always wants to go above and beyond because you care and believe what you do makes a difference – Adventist Health System is for you.

Under the direction of the Vice President of Revenue Management, the Executive Director of Revenue Integrity is responsible for overall management and operation of the chargemaster support, RN audit and reporting functions.  The Executive Director of Revenue Integrity is responsible for ensuring appropriate oversight and implementation of revenue integrity policies and procedures and overseeing the daily charge reconciliation and charge capture, compliant charging, and charge related clinical documentation. Performance of daily audits ensure that system documentation and interfaces are working properly, establishes structure, processes and governance for charge capture, CDM and charge process across the organization. This leader will be responsible for adopting and standardizing best practice structures, processes and monitoring adherence for accuracy of all hospital Charge Description Masters (CDMs) code assignment to ensure charges are maximized for reimbursement and accurate and appropriate charge code assignment and charge processes.  Facilitate all necessary training to hospital and department leaders; oversee vendors and staff responsible for charge auditing and corrections. The Executive Director Revenue Integrity is responsible for ensuring the appropriate technology tools are implemented, optimized and utilized throughout the system to support best practice revenue integrity, charge capture processes and revenue cycle performance reporting. These areas interact with all levels of management and staff across AHS facilities, AHS headquarters as well as with outside entities such as payers, vendor partners, and government agencies.


Qualifications

What you will be responsible for:

  • Lead and direct the corporate RN Audit, Chargemaster Support, and Reporting and Analytics departments located at AHS headquarters, including the day to day priorities and tasks of the Directors of Chargemaster Support, RN Audit, and Reporting and Analytics.
  • In collaboration with local hospital Chief Financial Officers and Regional Revenue Cycle executives, lead and direct the Revenue management and Nurse Auditing function across AHS in the successful management of their respective duties, resulting in accurate, timely documentation which drives charge processing and interfaced charges.
  • Develop the annual budget for Chargemaster Support, Nurse Audit, and Reporting and manage expenses accordingly to stay within budget parameters. 
  • Lead development reporting key revenue cycle performance metrics, striving to keep metrics consistent and comparable across the organization with consistent validated sources.
  • Responsible for formulating Revenue Cycle reporting and analytics strategies and determining priorities for the development of additional capabilities.
  • Facilitate and contribute to successful IT system implementations and on-going management, including Patient Accounting systems, chargemaster maintenance tools, and reporting and analytics capabilities.
  • Consult and collaborate with corporate, division, hospital, SSC and individual department leaders to develop overall strategy and objectives for revenue integrity that are aligned with the organization s and hospitals short, medium and long term goals and objectives
  • Proactively work with hospital CFOs, division vice presidents, corporate leadership to ensure adoption of standard processes and industry leading best practices
  • Collaborate with compliance by providing direction and support to timely resolve issues identified
  • Create a consolidated CDM structure with monitoring; Develop a methodology and committee structure to manage new CDM line item additions.
  • Provide leadership and support to the revenue integrity / charge capture operation for the hospital s clinical departments
  • Lead and manage a group of registered nurses, charge specialists, to assure accurate charge processes and maintain revenue integrity
  • Assure rules based revenue charge capture technology is implemented consistently to identify charge errors and inaccuracies is appropriately implemented and utilized throughout the system; facilitate policy / procedure changes and educate and train staff to correct charge capture and revenue integrity issues identified using vendor
  • Optimize and standardize current processes, develop solutions for performance shortfalls and monitor to ensure consistent adherence to policies and procedures across all hospitals. Collaborate with other hospital revenue cycle operational leaders to identify problems and determine solutions that improve and/or enhance overall operations and results Identify new technology, tools and key initiatives to reduce cost and/or improve yield across the revenue cycle
  • Develops, assesses, and adapts clear and effective charge capture process, policies and procedures, training, communications and awareness material from a revenue integrity perspective.
  • Provide on-site support at local hospitals and hospital centralized business offices as needed.
  • Monitors and analyzes charge capture trends and assess auditing and monitoring trends and coordinate mitigation activities when opportunities for improvement (audit variances) are identified.
  • Works with AIT, Corporate Analytics and Business Intelligence to develop reporting and analytics to support the business operations of the Revenue Cycle.
  • Works with leaders across the organization to identify opportunities to capture all charges efficiently
 
What you will need:
  • Bachelor’s Degree in finance, accounting or other business field
  • Three to five years’ experience in hospital-related accounts receivable/revenue cycle management
  • Proficient in Microsoft Office applications, especially Excel, Word and Power Point
  • Ability to quickly learn new hardware and software applications, including legacy/core patient accounting systems
  • Keeps abreast of changing industry requirements and regulations regarding acceptable documentation and billing practices by reviewing Federal Register, fraud alerts, OIG advisory opinions and other relevant publications. Communicates changes to impacted leaders and provides education on such changes.
  • Maintain an awareness of current laws, statutes, regulations, etc. that impact healthcare operations and revenue cycle specifically.
  • Demonstrated ability to be self-directed and work with minimal supervision/oversight


This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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