Cedars-Sinai Exec Dir, Compliance & Revenue Integrity in Los Angeles, California
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The Executive Director, Compliance & Revenue Integrity is responsible for promoting the financial viability of the organization by effectively managing aspects of the revenue capture operations. Provides guidance and oversight for charge description master integrity, patient account charge audits, regulatory audits and appeals, underpayment recovery and denials management for the hospital and physician clinic services. Supports and manages the technical charge capture systems, processes and workflows of revenue generating departments for the organization to ensure timely and accurate recording of revenue, in accordance with all applicable governmental and institutional standards, bylaws, rules and regulations. Provides information to charge capture teams and operational directors/managers related to mechanisms of charge triggers, controls and reconciliation, and coding purposes of compliant billing and charging procedures.
Primary Duties and Responsibilities:
Oversees the implementation of programs, policies, initiatives, and tools for Charge Capture, including but not limited to institutional system-wide charge capture processes are handled with efficiency.
Develops policies and procedures, monitoring tools for late charges and establishment of procedures for timely and accurate charge capture mechanisms.
Develops and maintains collaborative working relationship with revenue producing departments, information systems personnel, technical and clinical personnel to identify chargeable activities, to establish charge capture mechanisms, and orderly and timely recording of revenue.
Collaborates with Clinical Physician Leaders and Departments to review new technologies and establish related charge capture and coding protocols.
Directs and facilitates the development of corrective action plans related to any deficiencies noted concerning charge capture effectiveness and system integration.
Bachelor's degree in Business Administration, Healthcare Administration and/or related field required
Master's degree in Business Administration, Healthcare Administration and/or related field preferred
12 years of relevant experience within Revenue Integrity required
5 years of Management / Supervisory experience required
Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.