System Director, Revenue Integrity

MMS Group

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Job Details:

Job Overview:
Job Title: System Director, Revenue Integrity
Employer: MMS Group
Location: New Orleans, Louisiana
Job Type: Full-Time
Profession: Administrator/Executive
Career Level: Experienced
Experience: 5-10 years
Education Level: Bachelor’s Degree
Travel: none

Job Description:
Reporting to the AVP of HIM Ops, Coding, CDI & RI, this position contributes to Health’System’s financial strength, compliance and overall performance by serving in a directorial capacity for all Revenue Integrity functions.  As such, this position is responsible for maintaining a strategic and leadership role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation.

This individual is responsible for ensuring adherence to applicable governmental and payer regulations. The incumbent assumes responsibility for operational management, as well as administrative and fiscal matters pertaining to Revenue Integrity.

Responsible for developing standards and ensuring the integrity of the integrated professional and facility revenue charge capture; includes all aspects of the Charge Description Master (CDM) and fee schedule formulation(s), review and maintenance to optimize revenue generation, and maintain compliance with government and third party payer requirements; charge entry and reconciliation; collaboration with all service lines across the Health System; policy and procedure development, modification and maintenance.

Job Requirements:
Education:
Minimum Required:  Minimum of a bachelor or associates degree in HIM health services administration, or other related health care field required.
Preferred:  MBA or MBA/Healthcare.

Experience:
Minimum Required:  Five years of experience in HIM or healthcare management of which 3 years must be at the supervisory level or above.  Extensive clinical operations and/or clinical coding knowledge.
Preferred:  Nursing or clinical experience.

License/Certification:
Minimum Required: RHIT or Hospital (CCS) or Professional Certification (CPC, CCA, CPC-H).
Preferred: RHIA

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About MMS Group:
MMS is a Managed Care executive search firm. We are Managed Care’s complete recruiting resource.

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