Director Revenue Integrity
Company Name:
Huggins Hospital
Under the direction of theRevenue Cycle Director and within established Hospital and departmental policies and procedures, is responsible for maintaining the integrity of revenue capture across the revenue generating departments of Huggins Hospital and Physician Practices. Responsible for ensuring data integrity across all systems and reporting key indicators of organizational performance.
This is a full time position.
A Bachelor's degree in Business, Finance, Accounting, Information Management, Healthcare Information, Computing, Mathematics, Statistics, orrelated fields.
Advanced degree or credential in Business or Accounting such as CPA or MBA
Certification in billing and coding represented by any of the following RHIA, RHIT, RN, CPC, CPC-H, CCS, or CCS-P
1. Revenue Integrity
Maintenance of the charge master to ensure all federal, state and local payer requirements are incorporated into the CDM,
communication with and education of the clinical areas as it relates to the revenue cycle, the CDM, the charge capture process and charge reconciliation
Review, on an annual basis and / or as otherwise identified, all areas treating patients to ensure the capture of all professional and facility billable charges. This review is inclusive of, but not limited to, the departmental CDM, fee schedule encounter forms, systems generating charges (especially any mappings in an ancillary charge systems), order entry systems, reconciliation processes, revenue and usage reports, CPT / HCPCS codes, ICD-9 (ICD-10) codes and revenue codes.
work closely with the Director of Revenue Cycle Services to monitor, audit and measure the effectiveness of the revenue cycle process including charge capture and reconciliation procedures
Monitor payor performance and adherence to contracts
Conduct and analyzes hospital audits, both external and internal,
Ensures documentation in medical records supports charges
Work closely with Nursing making nurses accountable for auditing daily charges
Monitor and trend denials, identifying root causes, and provide departmental feedback
2. Data Integrity and Information Management
Develop, document, and maintain data standards and quality goals
Monitor data quality using system auditing tools and reporting back to departments
Provides data and analysis in appropriate presentation form
Provides the organization with standard reporting on key performance indicators
Analyzes, evaluates and documents data requests to understand and prioritize requests appropriately.
Establishes and administers database standards, including testing procedures.
Advises users and management on database concepts and functional capabilities.
Works closely with various departments to develop data-driven solutions.
Ensures valid and accurate content of data elements.
Develops processes to capture and track changes made to the data.
Performs queries of external databases to obtain data for appending to internal reports
3. Daily Operations
Identify problematic areas and conduct research to determine the best course of action to correct the data
Analyze and problem solve issues with current and planned systems as they relate to the integration and management of patient data (for example, review for accuracy in record merge, unmerge processes)
Analyze reports of data duplicates or other errors to provide ongoing appropriate inter-departmental communication and monthly or daily data reports (for example, related to the EMPI)
Monitor for timely and accurate completion of select data elements (for example, verbal physician orders)
Identify, analyze, and interpret trends or patterns in complex data sets
Monitor data table statistics
4. Data Capture
In collaboration with others, develop and maintain databases and data systems necessary for projects and department functions
Acquire and abstract primary or secondary data from existing internal or external data sources
In collaboration with others, develop and implement data collection systems and other strategies that optimize statistical efficiency and data quality
Perform data entry, either manually or using scanning technology, when needed or required
5. Data Reporting
In collaboration with others, interpret data and develop recommendations based on findings
Develop graphs, reports, and presentations of project results
Perform basic statistical analyses for projects and reports
Create and present quality and key performance indicator dashboards
Generate routine and ad hoc reports
Date: 2014-07-10
Country: US
State: NH
City: Wolfeboro
Postal Code: 03894Estimated Salary: $20 to $28 per hour based on qualifications.
Huggins Hospital
Under the direction of theRevenue Cycle Director and within established Hospital and departmental policies and procedures, is responsible for maintaining the integrity of revenue capture across the revenue generating departments of Huggins Hospital and Physician Practices. Responsible for ensuring data integrity across all systems and reporting key indicators of organizational performance.
This is a full time position.
A Bachelor's degree in Business, Finance, Accounting, Information Management, Healthcare Information, Computing, Mathematics, Statistics, orrelated fields.
Advanced degree or credential in Business or Accounting such as CPA or MBA
Certification in billing and coding represented by any of the following RHIA, RHIT, RN, CPC, CPC-H, CCS, or CCS-P
1. Revenue Integrity
Maintenance of the charge master to ensure all federal, state and local payer requirements are incorporated into the CDM,
communication with and education of the clinical areas as it relates to the revenue cycle, the CDM, the charge capture process and charge reconciliation
Review, on an annual basis and / or as otherwise identified, all areas treating patients to ensure the capture of all professional and facility billable charges. This review is inclusive of, but not limited to, the departmental CDM, fee schedule encounter forms, systems generating charges (especially any mappings in an ancillary charge systems), order entry systems, reconciliation processes, revenue and usage reports, CPT / HCPCS codes, ICD-9 (ICD-10) codes and revenue codes.
work closely with the Director of Revenue Cycle Services to monitor, audit and measure the effectiveness of the revenue cycle process including charge capture and reconciliation procedures
Monitor payor performance and adherence to contracts
Conduct and analyzes hospital audits, both external and internal,
Ensures documentation in medical records supports charges
Work closely with Nursing making nurses accountable for auditing daily charges
Monitor and trend denials, identifying root causes, and provide departmental feedback
2. Data Integrity and Information Management
Develop, document, and maintain data standards and quality goals
Monitor data quality using system auditing tools and reporting back to departments
Provides data and analysis in appropriate presentation form
Provides the organization with standard reporting on key performance indicators
Analyzes, evaluates and documents data requests to understand and prioritize requests appropriately.
Establishes and administers database standards, including testing procedures.
Advises users and management on database concepts and functional capabilities.
Works closely with various departments to develop data-driven solutions.
Ensures valid and accurate content of data elements.
Develops processes to capture and track changes made to the data.
Performs queries of external databases to obtain data for appending to internal reports
3. Daily Operations
Identify problematic areas and conduct research to determine the best course of action to correct the data
Analyze and problem solve issues with current and planned systems as they relate to the integration and management of patient data (for example, review for accuracy in record merge, unmerge processes)
Analyze reports of data duplicates or other errors to provide ongoing appropriate inter-departmental communication and monthly or daily data reports (for example, related to the EMPI)
Monitor for timely and accurate completion of select data elements (for example, verbal physician orders)
Identify, analyze, and interpret trends or patterns in complex data sets
Monitor data table statistics
4. Data Capture
In collaboration with others, develop and maintain databases and data systems necessary for projects and department functions
Acquire and abstract primary or secondary data from existing internal or external data sources
In collaboration with others, develop and implement data collection systems and other strategies that optimize statistical efficiency and data quality
Perform data entry, either manually or using scanning technology, when needed or required
5. Data Reporting
In collaboration with others, interpret data and develop recommendations based on findings
Develop graphs, reports, and presentations of project results
Perform basic statistical analyses for projects and reports
Create and present quality and key performance indicator dashboards
Generate routine and ad hoc reports
Date: 2014-07-10
Country: US
State: NH
City: Wolfeboro
Postal Code: 03894Estimated Salary: $20 to $28 per hour based on qualifications.
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