Revenue Integrity Director - Professional Services

Memorial Hermann Health System; Salt Lake City (UT); Sur place; USD 180 000 - 240 000; Plein temps

Résumé du poste

Memorial Hermann Health System seeks a Director of Professional Revenue Integrity to lead the department responsible for all professional services revenue integrity processes, pricing, and compliance. The role requires extensive Epic experience and strong strategic leadership across Revenue Cycle, Clinical Departments, Networking and Finance.

Candidate should demonstrate a track record of implementing performance improvements, data analytics, and team development in a large health system,

Qualifications

• Ten years of Physician/Professional Billing experience with at least five years in a management level position for a large health system.
• Extensive knowledge and experience with Epic EMR system, specifically with EPIC Resolute Billing with a large health system.
• Experience in Charge Capture, Charge Reconciliation, Charge Pricing, Charge Routing, and Reimbursement.
• Comprehensive understanding of healthcare billing and coding systems (e.g., HCPCS, ICD-10).
• Proven analytical ability, organizational and critical thinking skills to analyze problems based on data analytics and devise actions.

Responsabilités

• Oversees all facets of professional services revenue integrity processes to achieve benchmarks.
• Partners with senior leadership to establish best practices for revenue integrity including coding and clinical documentation.
• Enhances financial performance by optimizing charge capture, reconciliation and maximizing reimbursement.
• Monitors governance of daily charge reconciliation procedures and engages departments.
• Provides pricing methodology guidance through fee schedule maintenance.
• Advises on payer trends and adjudication procedures as necessary.
• Promotes data-driven improvements by root cause analysis and education.
• Develops strategy, goals, budgets and performance standards for revenue integrity.
• Delivers updates to leadership on findings and risks; participates in committees and projects.
• Ensures compliance with HIPAA and other regulations.

Connaissances

Leadership experience

Revenue Cycle

Epic Resolute Billing

Data Analytics

Microsoft Excel

Communication

Project Management

Formation

Bachelor’s degree in Healthcare Administration, Business Management, Accounting or related field

Certified Professional Coder (CPC)

Certified Medical Coder (CMC)

Epic certification such as ARCR: Resolute Professional Billing Claims

Project Management Professional (PMP)

Outils

EPIC Resolute Billing

Microsoft Word

PowerPoint

Description du poste

Memorial Hermann Health System seeks a Director of Professional Revenue Integrity to lead the department responsible for all professional services revenue integrity processes, pricing, and compliance. The role requires extensive Epic experience and strong strategic leadership across Revenue Cycle, Clinical Departments, Networking and Finance.

Candidate should demonstrate a track record of implementing performance improvements, data analytics, and team development in a large health system,