Associate Director, Revenue Integrity

Banner Health

Northern (KY)

Hybrid

USD 51,000 - 85,000

Full time

5 days ago
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Job summary

Banner Health is seeking an Associate Director of Revenue Integrity to lead a team focused on charge capture optimization and compliance across the revenue cycle. This remote role supports governance and standardization of processes to improve reimbursement and reduce leakage.

The ideal candidate will bring 5+ years in Revenue Integrity, strong leadership for direct reports, and a deep understanding of ICD/DRG and CPT coding alongside CMS regulations.

Qualifications

  • Bachelor's degree in business, healthcare administration or equivalent work experience.
  • Five+ years in Revenue Integrity (recent).
  • Leadership experience with direct reports (2+ years).
  • RHIA/RHIT/CCS or CPC certifications or active equivalents preferred.

Responsibilities

  • Monitor and trend financial data related to charge capture toward revenue cycle goals.
  • Oversee Revenue Integrity staff and liaise with clinical/operational departments.
  • Educate and manage Revenue Integrity Specialists on charging trends and corrective actions.
  • Ensure billable items are charged accurately and timely across hospital and clinics.
  • Provide updates to the Steering Committee with remediation actions.

Skills

Charge capture
Revenue integrity
Leadership
Regulatory knowledge

Education

Bachelor's degree in business or healthcare administration
RHIA/RHIT/CCS or CPC certification options

Job description

## Associate Director, Revenue IntegrityApply: Remote: Remote Arizona: Full time: Posted Today: R4454829**Department Name:**Revenue Integrity-Corp**Work Shift:**Day**Job Category:**Revenue CycleInnovation and highly trained staff. Banner Health recently earned Great Place To Work CertificationTM. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Banner Health the best place to work and receive care. As an Associate Director of Revenue Integrity you will be an integral part of leadership within the team. During your typical duties, you will have the opportunity to educate and develop team members, roll out process changes and projects, as well as troubleshooting questions from your team and outside stakeholders, and conducting review of findings. Location: Remote, Banner does supply equipmentShift: Exempt position, Full time, Mon-FriIdeal Candidate:* **Bachelors degree in business, healthcare administration or equivalent work experience;*** **5+ years recent experience in Revenue Integrity (clearly reflected in your attached resume);*** **At least 2 years of experience within leadership role, including performance management of direct reports.** **This can be a remote position if you live in the following state(s) only: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR PA, SC, TN, TX, UT, VA, WA, WI, WV, WY**Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefitsWithin Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.POSITION SUMMARY This position, under the direction of the Revenue Integrity Director, will provide operational oversight of the Revenue Integrity Analyst team. Responsibilities include revenue optimization through implementing standard charge capture reconciliation, charge capture review initiatives, charge capture education and process to ensure charge capture integrity and revenue optimization in compliance with CMS and other regulatory agencies. CORE FUNCTIONS 1. Monitors and trends financial data related to charge capture progress toward revenue cycle goals, identifies variances and implements process improvement as necessary to enhance compliant revenue optimization. 2. Provide operational oversight of the revenue integrity staff and serve as a liaison between Revenue Integrity and clinical/operational departments to escalate charge issues and inquiries to key stakeholders. Supports finance, operations, and revenue cycle teams through special projects. 3. Develop, educate and manage Revenue Integrity Specialists, supporting them in analyzing, communicating and educating hospital and clinics regarding deficient charging trends and corrective action plans to resolve deficiencies. 4. Engage with clinical areas and revenue cycle departments across Banner to confirm billable items and services are charged appropriately and in a timely manner. 5. Provide revenue integrity recommendations and updates to the Revenue Integrity Steering Committee with potential actions for remediation. Upon resolution and approval of recommendations confirm appropriate actions are carried out accurately and completely. 6. Maintains current knowledge of regulatory changes impacting charge practices. Develops charge capture and reconciliation policy and procedures. Monitor/report monthly KPI Revenue integrity metrics dashboard. 7. Implement charge capture review program for hospital revenue generating departments. Coordinates processes between operations and revenue cycle departments ensuring that the accounts reviewed reflect proper documentation, charge capture, coding and billing to support proper payment. 8. Manages charge reviews to ensure annual coding changes/new service lines incorporated into charge master flow correctly to the patient bill. Purpose of these special projects are department specific and the goal is to identify potential compliance issues and revenue leakage issues. 9. Works independently under limited supervision. Makes independent judgments based on specialized knowledge. Holds system-wide responsibility for managing the company’s charge capture, charge reconciliation and chart reviews related to charging issues. Internal customers: company leadership, company’s compliance committees, revenue cycle team, physicians and clinical staff. MINIMUM QUALIFICATIONS Must possess a strong knowledge of business and/or healthcare as normally obtained through the completion of a bachelor’s degree in business, health care administration or previous work experience. In the acute care environment, may require a Registered Health Information Administrator (RHIA), Registered Health Information Technologist (RHIT) or Certified Coding Specialist (CCS) in an active status with American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC), or relevant work experience. In the ambulatory setting, requires Certified Professional Coder (CPC) certification or Certified Coding Specialist-Physician (CCS-P), with RHIA, RHIT or CCS, or relevant work experience. Requires proficiency typically obtained with five or more years of health care coding and billing experience. Must possess a thorough knowledge of ICD/DRG coding and/or CPT coding principles, and the recommended American Health Information Management Association coding competencies. Requires an in-depth knowledge of medical terminology, anatomy and physiology, plus a thorough understanding of the content of the clinical record and an extensive knowledge of all coding conventions and reimbursement guidelines, across all services lines, LCD/NCDs and MAC/FIs. Extensive critical and analytical thinking skills required. Ability to organize workload to meet deadlines and maintain confidentiality of all work information. Ability to research, interpret and develop recommendations. Excellent written and oral communication skills are required, as well as effective human relations and leadership skills for building and maintaining a working relationship with all levels of staff, physicians, and other contacts. PREFERRED QUALIFICATIONS Additional related education and/or experience preferred.**Estimated Pay Range:**$37.14 - $61.90 / hour
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