Director Revenue Integrity

Job ID: J124064
Company: West Penn Allegheny Health System
Location: Pittsburgh, PA, United States
Facility: 4 Allegheny Center
Full/Part Time: Full time
Job Type: Regular
Posted at: May 31, 2018

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Description

GENERAL OVERVIEW:

Reporting to the Vice President, Central Billing Office, responsible for ensuring that the health system maintains financial health through a complete and accurate charge listing and charging process maintaining compliance with all federal and regulatory requirements.

ESSENTIAL RESPONSIBILITIES:

  • Oversees health system charge description master, ensuring all chargeable activities are reflected appropriately in the Charge Description Master (CDM). (20%)
  • Directs and oversees plan to move hospitals from legacy systems to EPIC with a consolidated Charge Description Master (CDM). (20%)
  • Monitors, evaluates and updates CDM pricing associated with reimbursement changes and strategic initiatives. (20%)
  • Oversees revenue integrity of clinical departments providing education, training and tools for departments to successfully capture clinical into charge capture. (20%)
  • Supervises revenue integrity team providing direction and guidance that fosters a team environment through training, recognition/evaluation and in-service education which produces optimum work habits. Mentors and coaches to achieve highest level of competency of leadership and staff. (10%)
  • Prepares, monitors, and maintains an annual expense budget. (10%)

QUALIFICATIONS:

Minimum

  • Bachelor's degree in Finance or Health related field
  • EPIC certification in CDM
  • Five years healthcare coding/revenue integrity experience
  • Three years leadership experience

Preferred

  • RHIA

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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