Sr. Director of Revenue Integrity

<br />The Senior Director of Revenue Integrity will support the AVP of Revenue Integrity in the setting the standards of the Charge Description Master (CDM) and ensure the integrity of charge capture across the organization.


The Kipton Group

The Kipton Group specializes in Talent Advising and Recruitment Marketing. We are experienced in sourcing, end-to-end recruitment and building brand awareness. Our goal is to help our clients build and communicate an authentic and compelling talent brand and hire quality candidates.

keywords: audit,compliance,analysis,relationships,teamwork,culture,leadership,communication,creative,goals,education,experience,project management,certification

Sr. Director

up to $150,000 plus bonus

Overview: <p><span style="font-size: 10.5pt; font-family: Helvetica;">The Senior Director of Revenue Integrity is responsible for developing a charge audit/capture/reconciliation process and ensuring charges are maximized for reimbursement. The Senior Director of Revenue Integrity also provides oversight and response for internal and external audit requests to be conducted by clinical nurse auditors as needed. The Senior Director of Revenue Integrity also participates in compliance related activities and denials root cause and process improvement, as appropriate.</span></p>
Responsibilities: <p>Essential Functions:</p> <p>Performs analysis of gross revenue, pricing and charge capture effectiveness and develops action plans and educational material to ensure Key Performance Metrics meet or exceed best practice.</p> <p>Guides and directs the team and activities related to the development of annual pricing strategies to ensure maximum net revenue capture while maintaining market relevance;&nbsp;&nbsp; annual education regarding compliance or payor-specific changes related to charging practices; and system functionality development and implementation to improve charge capture methods.</p> <p>Organizes functions through establishing clear accountabilities and decision rights, the delegation of duties and appropriate departmentalization without creating silos.&nbsp; Develops and maintains an effective, visible and well-respected leadership team by selecting, evaluating, coaching and managing the performance of qualified professional.</p> <p>Participates in monthly, quarterly and annual key indicator goal setting.&nbsp; Prepares and presents the annual business plan, including goals and review of prior year results.</p> <p>Leads the review, recommendation, and implementation of the modernization of all systems.</p> <p>Accountable for a comprehensive and effective communication strategy with the department that promotes a common understanding of the market, vision, strategy, and accountabilities.&nbsp; Promotes a culture of two-way communications and creates opportunities for staff participation.&nbsp;</p> Activities focused on associate engagement, including intentional coaching and mentoring
Requirements: <p><strong>Qualifications -</strong></p> <p>Required Minimum Education:&nbsp; Bachelor Degree</p> <p>Preferred Education: Graduate Degree<br /><span style="font-size: 10.5pt; font-family: Helvetica;"><br />Combination of post-secondary education and experience will be considered in lieu of degree.</span></p> <p><span style="font-size: 10.5pt; font-family: Helvetica;">Preferred Certifications: Coding certification in at least one of the following: CPC, CPC-P, CPC-H or Certification in Auditing and / or Healthcare Compliance.</span></p> <p><span style="font-size: 10.5pt; font-family: Helvetica;">Minimum Years and Type of Experience: 5-10 years experience in Revenue Integrity / CDM. 5 years in a leadership role. Project Management experience. Epic experience preferred.</span></p>