Revenue Integrity Director - Nashville
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Job Code: 26012-123350
Parallon believes that organizations that continuously learn and improve will thrive. That's why, after more than a decade, Parallon remains dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future.
As one of the healthcare industry's leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized services in the areas of revenue cycle, purchasing, supply chain, technology, workforce management and consulting.
Parallon's purpose is simple. We serve and enable those who care for and improve human life in their communities.
The REVENUE INTEGRITY DIRECTOR is responsible for the daily operations of all functions and oversight of the RI team members and serves as the liaison between the Revenue Integrity Department of Shared Services and the facility. As the leader, this person will serve as a key promoter of the Service Center, which strives to meet and exceed the needs of its customers. The director supervises staff and organizes the structure of the program and coordinates the transition process for staff to become affiliated with Patient Account Services. The director monitors and tracks status of all PAS department responsibilities regarding the transition process. The director establishes and maintains relationships with all customers, including: PAS executive staff, RI staff, hospital executive management teams, department directors and others. The director also consults with hospitals concerning daily operations and general management of the processes. This position will involve developing educational programs, allocating and assigning duties to employees, and monitoring the activities and operations to ensure all regulatory guidelines are met and that established goals are met within required deadlines.
Additional responsibilities include conducting onsite visits to facilities, assessing workflows and operations, drafting plans for process improvement and carrying out the implementation and follow up of improvements. Other responsibilities as assigned and/or needed.
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
Monitor and communicate any changes regarding CMS Notifications, Local Coverage Decisions (LCD) NCD (National Coverage Determinations and HCA Government Regs to Revenue Integrity staff
Maintain up-to-date knowledge of regulatory changes impacting charging practices
Coordinate the transition process for staff to become affiliated with HCA Patient Account Service Center
Monitor and track status of all department responsibilities regarding the transition process
Establish and maintain relationships with all customers, including: PAS executive management team, hospital executive management, department directors, Revenue Integrity staff and others as needed or required
Assess current front/back office operations, design and implement process improvements and conduct follow up review and measurement of changes
Consult with management concerning daily operations and general management of the operations
Develop educational programs, allocate and assign duties to employees, and monitor the activities and operations of assigned facilities, along with staff
Perform on-site analysis of processes and Revenue Cycle Management as well as conducting follow up analysis of post-implementation operations
Draft summary reports and make presentations to PAS Management Team, Facility Management Team and other staff during and post transition
Review and make operational recommendations prior to, during and post transition
Interpret and analyze AR Reports, such as, Bill 45, Bill 49, DET Reports across all facilities etc.
Work diligently with PAS staff and Compliance to ensure integrity of revenue is maintained
Adhere to all current Compliance requirements
Maintain strictest confidentiality to ensure that privileged and/or proprietary information is adequately safeguarded against disclosure
Practice and adhere to the Code of Conduct philosophy and Mission and Value Statement .
Other duties as assigned
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
KNOWLEDGE, SKILLS, & ABILITIES - This position requires the following minimum requirements:
Familiarity with daily operations of Revenue Cycle
Understands basic payer rules, which affect reimbursement and/or compliance requirements
Familiarity with the integration of major components of the Revenue Cycle, including patient registration, coding, charging, managed care, cash management and billing
Understands front/back office operations, patient flow, and staff work assignments
Well developed ability to organize, plan and develop processes start to finish
Detail oriented and able to work with minimal supervision
Ability to meet deadlines
Supervise staff and organize the structure of the program
Organization - proactively prioritizes needs and effectively manages resources
Communication - communicates clearly and concisely with strong presentation skills
Leadership - guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations is critical
Tactical execution - oversees the development, deployment and direction of complex programs and processes
Policies & Procedures - articulates knowledge and understanding of organizational policies, procedures and all systems, PA Host, Meditech etc.
PC skills - demonstrates proficiency in Microsoft Office, Word, PowerPoint, Excel, Outlook, and other applications as required
Ability to perform Project Management - assesses work activities and allocates resources appropriately
EDUCATION AND/OR EXPERIENCE
High School diploma or GED required.
Undergraduate degree preferred.
Three years of healthcare experience required
Clinical experience preferred.
Previous management experience required.
CERTIFICATE/LICENSE - LPN, LVN or RN preferred
Last Edited: 08/10/2016