Director - Revenue Integrity and Optimization - MPE - FT - Days - MSS
Memorial Healthcare System

Location:
Miramar, Florida
At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.

Summary:

The Director - Revenue Integrity and Optimization provides strategic direction and oversight of various revenue cycle functions to ensure the integrity of the organization's revenue for professional billing. This includes revenue optimization, prevention of revenue leakage, and direction and oversight related to charge capture, charge reconciliation and other reimbursement matters.

Responsibilities:

Uses data and reports to perform root cause analysis to identify areas of strengths, weaknesses, opportunities, and threats to organizational revenue integrity. Collaborate and recommend solutions that mitigate risk and optimizes revenue opportunities.Provides expertise as it relates to billing and coding compliance for new and existing services, while ensuring compliance with organizational, federal, state, and third party requirements.Leads reporting and analysis process of revenue related data and defines and implements revenue related process improvement. Ensures proper health care reimbursements for professional billing accounts and must continually coordinate between administrative and clinical operations staff to ensure that accounts have the correct coding, billing, payment, and charge captures.Fulfills the primary leadership role between Finance, Coding Department, and Providers to develop, champion, communicate, and execute MPG revenue integrity objectives, to identify areas for process improvement in current business processes; identify opportunities to maximize revenue potential, and effectively communicate and execute these solutions.Develop methods to effectively communicate information through presentations, reports, educational programs, memoranda, etc. by providing formal and informal education to leaders and staff in other disciplines on revenue integrity topics.Lead and direct the Revenue Integrity quality assurance charge audits; establish, measure, and document KPI's and mitigation plans as needed, including Revenue Integrity Scorecard improvements and other quality controls needed to successfully monitor and control charging and billing integrity.

Competencies:

Education and Certification Requirements:

Bachelors: Finance (Required)

Additional Job Information:

Complexity of Work: This role requires critical thinking skills, effective communication, decisive judgement, and the ability to work with minimal supervision. The incumbent must be able to work in a stressful environment and take appropriate action when required. Required Work Experience: Seven (7) years of experience in healthcare, finance, revenue integrity, revenue cycle operations accounting or related fields. Other Information: Master's degree is preferred. Coding certification (CPC, CCS, CCS-P, COC), or certification in auditing/healthcare compliance or related course is preferred.Additional Education Info: or in Business, Healthcare, or IT related field.

Working Conditions and Physical Requirements:

• Bending and Stooping = 0%
• Climbing = 0%
• Keyboard Entry = 60%
• Kneeling = 0%
• Lifting/Carrying Patients 35 Pounds or Greater = 0%
• Lifting or Carrying 0 - 25 lbs Non-Patient = 0%
• Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%
• Lifting or Carrying > 75 lbs Non-Patient = 0%
• Pushing or Pulling 0 - 25 lbs Non-Patient = 0%
• Pushing or Pulling 26 - 75 lbs Non-Patient = 0%
• Pushing or Pulling > 75 lbs Non-Patient = 0%
• Reaching = 0%
• Repetitive Movement Foot/Leg = 0%
• Repetitive Movement Hand/Arm = 60%
• Running = 0%
• Sitting = 60%
• Squatting = 0%
• Standing = 60%
• Walking = 60%
• Audible Speech = 60%
• Hearing Acuity = 60%
• Smelling Acuity = 0%
• Taste Discrimination = 0%
• Depth Perception = 60%
• Distinguish Color = 60%
• Seeing - Far = 60%
• Seeing - Near = 60%
• Bio hazardous Waste = 0%
• Biological Hazards - Respiratory = 0%
• Biological Hazards - Skin or Ingestion = 0%
• Blood and/or Bodily Fluids = 0%
• Communicable Diseases and/or Pathogens = 0%
• Asbestos = 0%
• Cytotoxic Chemicals = 0%
• Dust = 0%
• Gas/Vapors/Fumes = 0%
• Hazardous Chemicals = 0%
• Hazardous Medication = 0%
• Latex = 0%
• Computer Monitor = 60%
• Domestic Animals = 0%
• Extreme Heat/Cold = 0%
• Fire Risk = 0%
• Hazardous Noise = 0%
• Heating Devices = 0%
• Hypoxia = 0%
• Laser/High Intensity Lights = 0%
• Magnetic Fields = 0%
• Moving Mechanical Parts = 0%
• Needles/Sharp Objects = 0%
• Potential Electric Shock = 0%
• Potential for Physical Assault = 0%
• Radiation = 0%
• Sudden Decompression During Flights = 0%
• Unprotected Heights = 0%
• Wet or Slippery Surfaces = 0%

Shift:

Days

Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.

Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.

Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.

Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.

We are proud to offer Veteran's Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.

Employment is subject to post offer, pre-placement assessment, including drug testing.

If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net

This job has expired.