Senior Director, Revenue Integrity Charge Description Master

ScionHealth is recruiting for a Senior Director, Revenue Integrity Charge Description Master to join our Revenue Cycle team!   

Job Summary

The Senior Director, Revenue Integrity Change Description Master shares in the Revenue Cycle creation of strategic direction for people, processes and technology while ensuring the accuracy of the charge description master and resources or technology to protect revenue and create revenue accuracy.  Responsible for reviewing, identifying, and analyzing necessary CPT changes related to quarterly and annual AMA CPT updates and regulatory changes by established timelines.

Accountable for development of work teams which demonstrate timeliness and accuracy of charge description master.  Ensure key performance targets and timelines are achieved.

Accountable for meeting the department goals and objectives including auditing, strategizing, and maintain performance accountability throughout the department.  Delegates authority and responsibility where appropriate and monitor progress on delegated tasks.  Provide opportunities for co-worker empowerment and growth.

This position provides leadership, direction, decision-making, and supports management and staff in best practice day to day revenue cycle functions relating to charge description master and revenue integrity. Must develop consistent policies and procedures which overlap with internal and external relationships such as information technology, legal, compliance, and internal audit.

Position may require travel to other markets.

Essential Functions

• Establishing goals by using industry benchmarks to stimulate best practice performance. Meets regularly with market leadership and to ensure department operations are working in accord to resolve any performance barriers.
• Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications.  Executes work plans to adapt systems and processes to accommodate changes.
• Clear understanding of financial objectives which includes forecasting, preparation of operating budget, monitoring expenditures, and understanding any variances while making recommendations and taking steps for corrective measures.
• Improves results by reviewing, evaluating processes, and analyzing results while implementing positive change management exercises. Constantly looking to seek opportunities for process improvement through technology for driving the business as well as through patient experience.
• Ensures that departments maintain current and in-depth knowledge of policies, procedures, and laws relating to CPT adds changes and deletions.  Also, responsible for implementing revenue protection measures as well as revenue recording accuracies.
• Processing CDM requests received from the clinical departments, or others, researching references and regulations to ensure correct coding and charging through the CDM.  Assigns charge codes as requested by revenue producing clinical departments and practices, working within system wide policies and procedures with direction from Revenue Integrity Liaisons.
• Works with Revenue Integrity Liaisons and clinical departments and practices creating new CDM items and pricing for new services and items.
• Provides mentoring, guidance, and expertise to CDM Coordinator role and assists in development of individuals in all CDM efforts.
• Ability to function independently and as a collaborator in a challenging environment required.

Education

• Bachelor's degree preferred in one of the following fields, Business Administration, Finance, or a related field. Alternatively, equivalent experience and education. 

License/Certification

• Preferred:  CPC, CPC-H, CCS, CCSP, PMP

Experience

• Three (3) prior years’ experience as CDM Coordinator or equivalent related experience.

Knowledge/Skills/Abilities

• Strong knowledge in the day-to-day operations of a physician business office.
• Prior work experience must include a significant role in a redesign project and/or management experience working in an automated environment.
• In-depth knowledge of and experience with reporting and projects associated with revenue cycle management and reimbursement procedures.

Position may be filled at a different level depending upon candidate’s qualifications.