System Director, Revenue Integrity

POSITION SUMMARY:

Reporting to the AVP of HIM Ops, Coding, CDI & RI, this position contributes to LCMC Health’s financial strength, compliance and overall performance by serving in a directorial capacity for all Revenue Integrity functions. As such, this position is responsible for maintaining a strategic and leadership role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation. This individual is responsible for ensuring adherence to applicable governmental and payer regulations. The incumbent assumes responsibility for operational management, as well as administrative and fiscal matters pertaining to Revenue Integrity.

Responsible for developing standards and ensuring the integrity of the integrated professional and facility revenue charge capture; includes all aspects of the Charge Description Master (CDM) and fee schedule formulation(s), review and maintenance to optimize revenue generation, and maintain compliance with government and third party payer requirements; charge entry and reconciliation; collaboration with all service lines across the Health System; policy and procedure development, modification and maintenance.

JOB DESCRIPTION DISCLAIMER:

The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.

JOB SPECIFICATIONS:

Education:

Minimum Required: Minimum of a bachelor or associates degree in HIM health services administration, or other related health care field required.

Preferred: MBA or MBA/Healthcare.

Experience:

Minimum Required: Five years of experience in HIM or healthcare management of which 3 years must be at the supervisory level or above. Extensive clinical operations and/or clinical coding knowledge.

Preferred: Nursing or clinical experience.

License/Certification:

Minimum Required: RHIT or Hospital (CCS) or Professional Certification (CPC, CCA, CPC-H).

Preferred: RHIA

Special Skills/Training:

Minimum Required:

1. A strategic vision balanced with operational competence.
2. Strong analytical background with ability to translate, communicate and present, at executive level, technical clinical and coding information and findings.
3. Extensive knowledge of charge creation, processing and reconciliation in a health care environment.
4. Knowledge of clinical workflows in both a paper based and electronic environment.
5. Significant experience with a fully developed electronic medical record (EMR); Epic experience preferred.
6. Extensive knowledge of hospital or professional coding including provider based billing.
7. Knowledge of regulations and accreditation standards, knowledge of specific state and federal requirements and standards related to the management of health information.
8. Excellent oral, written and interpersonal communication skills.
9. Exceptional leader with ability to foster staff motivation and a productive working environment.
10. Proven abilities related to project planning, management, and prioritization.
11. Ability to adapt to change and handle challenges proactively and with poise.
12. Ability to effectively collaborate with physicians and managerial staff at all levels.

Preferred: Knowledge of Epic electronic medical record and financial system.

Reporting Relationships:

Does this position formally supervise employees? Yes

If yes, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.