Director System Revenue Integrity

Purpose of Position: Develops and executes the strategic vision for system-wide Hospital, Professional and Ancillary Services Revenue Integrity functions within CCHC’s Revenue Cycle organization. Provides leadership and oversight of key operational and financial decisions pertaining to all underlying functions. Functional areas that report to this position include Charge Description Master (“CDM”) maintenance, charge capture and reconciliation related functions, payment variance, audit and appeals management, and denials management process audit review. Additionally, this role is responsible for defining efforts and focus areas to address denial root cause issues. Confirms that metrics are met, charge entry rates and accuracy rates are achieved to meet yearly revenue goals.Description ---------------

:* Lead the establishment and implementation of Key Performance Indicators (“KPIs”) for revenue integrity functions;

ensure the implementation of action plans where performance is not meeting expectations; review KPI expectations

annually and adjust appropriately; recognize areas of excellence. * Develop, implement, and oversee effective and consistent operational policies, processes, tools, and educational

materials within all Revenue Integrity functional areas. * Oversee the operational performance of a system-wide, service line-based Charge Review program dedicated to

identifying charge capture issues/improvement opportunities to minimize revenue leakage, through the use of technology

enablers and proactive internal audits/reviews of charging practices. * Ensure that the CDM is compliant with regulatory and payer requirements and that all services provided have an

established charging and reconciliation methodology. * Ensure Revenue Integrity employees across all functions comply with established policies, processes, and quality

assurance programs. * Identify potential process improvements in charge capture functions, and lead the des