Director of Revenue Cycle Management & Revenue Compliance

Location: Los Angeles, CA
Date Posted: 03-11-2019
CareNational
Director of Revenue Cycle Management & Revenue Compliance – Hospital 
Los Angeles, CA (near Beverly Hills)
 
Director of Revenue Cycle Management Job Summary: 
  • The Director reports to the Vice President of Revenue Cycle and Managed Care Operations and develops and directs, in coordination with Health System Corporate Integrity Program, a coding, documentation and data quality compliance program for Health System Medical Network.
  • The position ensures that the key elements of an effective revenue cycle compliance program are in place and operationalized as it relates to policies, education, risk assessments, profiling, work plan, monitoring, reporting and corrective/remedial actions and daily operations.
  • Responsible for planning, coordinating, implementing and monitoring of projects and initiatives relating to revenue cycle operations, and ensuring they are consistent with strategic mission.
  • Ensures compliance with state and federal laws, professional and regulatory agency standards and licensure requirements. Maintains staff compliance with health system and Foundation policies, procedures and protocols.
  • Functions as key resource for staff and physicians in utilization of key information systems and technologies. Assumes responsibility as practice liaison for the resolution of system related issues, identification of opportunities for improvement and implementation of key systems and system and workflow enhancements.
 
Director of Revenue Cycle Management Background:
 
  • Requires Bachelor’s Degree in Finance or Healthcare or related; Master’s degree is a plus.
  • Prefer certified coders from AHIMA or AAPC, such as CPC (Certified Procedural Coding) or CCS (Certified Coding Specialist)
  • At least 5 years’ management experience (Sr Manager/Director level) working in physician billing compliance in a large, preferably academic hospital/health system required.
  • Minimum of 5 years’ management (Sr Manager/Director) experience in researching complex coding compliance issues and questions, including the ability to develop effective education programs for adult learners (coders, physicians, nurses) is required.
  • Experience with the Compliance Program for Physician Practices from the Office of Inspector General (OIG) required.
  • Expertise with CPT-4 and ICD-10 coding and medical records documentation required.
  • Expertise of procedures and data flow in a health care organization; experience with physician billing preferred.
  • Knowledge of healthcare & insurance industry current and future trends, in order to assess future market needs.
  • Strong computer proficiency (MS Office) and typing skills are necessary.
  • Skilled in influencing, leading and directing individuals in multiple functional areas.
  • Able to transform assignments from high-level objectives into independently established detailed goals.
  • Excellent verbal and written communication skills, as well as exceptional critical thinking skills.
 
#CLINICAL
 
RON AMODIO
STRATEGIC DIRECTOR
CareNational
ron@carenational.com
480.269.9491 (CALL – TEXT – FAX)
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