Reporting to the Vice President of Revenue Cycle, the Director of Revenue Integrity is responsible for directing revenue integrity management, strategies, policies and procedures, budget process, project implementations, program expansions and committee representation. The Director ensures the effectiveness of the revenue integrity program, including overall consistency and integration of integrity activities throughout the organization. Maximizing revenue through the accurate and complete capture of all charges. The Director oversees changes and maintenance of the charge description master (CDM), and supports the organizations Financial Operations and Financial Planning teams to reconcile gross and net revenue, identify revenue trends and statistics, and proactively monitors and reports. Supports the corporate compliance program through education and verification of adherence to charge policies and procedures.

* This is a Remote position - "NAH reserves the right to make hiring decisions based in part on applicants' state of residence if outside the state of Arizona".

Charge Capture
• Oversees the charge capture team and system to promote accuracy and integrity

• Development of policies and procedures for reconciling charges posted

• Identify opportunities for charge capture improvement

• Coordinates and oversees hospital audit processes

• Champions and collaborates with acute and hospital outpatient designated areas, Managed Care, Finance, Compliance, and other revenue cycle stakeholders to identify revenue leakage, and monitor charge capture activities

CDM Maintenance
• Maintain/enhance system chargemaster structure to ensure charges accurately reflect services provided consistent with industry best practice

• Review changes in pricing, CPT codes, HCPCS codes and revenue codes for compliance with billing guidelines.

• Create and produce annual price adjustment policy and ensure effective roll out

Personnel Management
• Responsible for personnel issues, such as vacation, patient time off, and general time and attendance issues.

• Provides educational support to the inpatient and outpatient coding team.

• Implements corrective action plans based on trends identified by internal and external reviews and personnel issues.

• Demonstrates leadership using written, oral and interpersonal communication skills to effectively guide the work of reporting team to accomplish the delivery of the mission and vision of NAH through technology.

Compliance/Safety
• Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

• Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility.

• If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.

• Completes all company mandatory modules and required job-specific training in the specified time frame.

Analytics
• Identify and track potential areas of lost revenue. Builds relationships with service line leaders and works collaboratively to suggest/implement new revenue opportunities and/or mitigate areas of lost revenues

• Monitor Service Line charge reconciliation and proactively identify areas of concern

• Perform monthly revenue reconciliation procedures

• Work collaboratively with Fin Ops and Fin Plan on service line reconciliation/trends/solutions

• Suggest/create/executes charge capture/charge reconciliation automation

• Tracks trends in statistics and identifies areas of revenue concerns to budget

• Work Collaboratively with Revenue Cycle leaders to monitors denial trends and root cause and provide feedback as appropriate to reduce denials

Revenue Recognition/Management
• Works closely with leaders to ensure that the Revenue Integrity program meets applicable financial, operational, and legal requirements

• Responsible for a compliant System Pricing Policy (Updated annually)

• Responsible for a compliant Price Transparency Policy (Updated annually)

• Maintain and analyze revenue to ensure compliance with revenue recognition

Education
• Bachelor's Degree in related field or Equivalent Experience with 5+ years of Hospital operations management
• Bachelor's Degree or Equivalent in Accounting or Finance - Preferred

Experience
5 years Revenue Cycle management or Hospital Finance Operations- Required
2+ years Cerner/Oracle/Sorian EHR experience – Preferred
Revenue capture workflow creation and implementation experience - Required
Clinical health care setting revenue cycle experience, hospital preferred. - Required
Healthcare is a rapidly changing environment and technology is integrated into almost all aspects of patient care. Computers and other electronic devices are utilized across the organization and throughout each department. Colleagues must have an understanding of computers, and competence in using computers and basic software programs.

Certification & Licensures
• At least one of the following is preferred: Certified Coding Specialist (CCS), Certified Outpatient Coder (COC), Certified Procedural Hospital Coder (CPHC), or desire to obtain within 1 year of hiring