You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a Director of Revenue Integrity who will manage all facets of professional revenue integrity processes to achieve and exceed best practice benchmarks. The primary focus will be liaising between the revenue cycle and clinical departments, and contributing to the organization's financial performance through process enhancements, optimizing charge capture, and ensuring optimal reimbursement for services.
Key Responsibilities
- Manage professional revenue integrity processes and liaise between revenue cycle and clinical departments.
- Implement process enhancements to optimize charge capture and maximize revenue.
- Reconcile charges against daily ancillary and clinic patient schedules.
- Monitor daily reconciliation reports for accurate and timely charges.
- Maintain current knowledge of billing systems, claim submission, remittance advices, and payer requirements.
- Monitor charge review work queues and reports to identify improvement opportunities.
- Support best practices in professional services coding and clinical documentation.
- Utilize data-driven approaches to prioritize improvements from denial analysis.
- Ensure revenue integrity team activities comply with Federal, State, and payer regulations.
- Coordinate strategic plans to ensure progressive and effective revenue integrity department.
- Effectively communicate with managers and staff, and participate in performance management initiatives.
- Oversee personnel management, staffing levels, and productivity.
- Coordinate training for new and existing staff on applicable policies and procedures.
- Ensure compliance with HIPAA and other relevant laws and standards.
- Promote professional growth and development of staff, and serve as preceptor and mentor.
- Adhere to policies and standards to ensure safe patient care.
Qualifications
- Proficiency in managing professional revenue integrity processes.
- Experience with billing systems, claim submissions, payer systems, general coding, APC, CPT, and HCPCs.
- Strong communication and performance management skills.
- Ability to guide teams and implement process improvements.
Benefits
- Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
