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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
Working Title: Exec Dir, Compliance & Revenue Integrity
Providing healthcare for more than 100 years, Cedars-Sinai has evolved into one of the most dynamic and highly renowned medical centers in the world. Along with caring for patients, Cedars-Sinai is a hub for biomedical research and a training center for future physicians and other healthcare professionals. This attracts exceptional talent to Cedars-Sinai, including world-renowned physician-scientists who seek a place where they can both conduct research and see patients--the ideal formula for discovery and its translation into cures. Our patients benefit from access to doctors at the top of their fields, and our researchers have an ideal community in which to study the impact of healthcare challenges, and reflect that knowledge in their research. The greater Los Angeles area in which Cedars-Sinai resides possesses unparalleled cultural and ethnic diversity which offers outstanding opportunities for translational and clinical research and a dynamic environment for medical education.Although community based, Cedars-Sinai is a major t...eaching hospital affiliated with the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Cedars-Sinai has highly competitive graduate medical education programs in more than 50 specialty and subspecialty areas, a graduate program in biomedical sciences and translational medicine, a clinical scholars program directed towards junior physicians with aspirations to become clinical scientists, and post graduate training opportunities.There are more than 250 full-time faculty members at Cedars-Sinai. The voluntary medical staff, comprised of more than 2,200 specialty board-certified or board-qualified physicians, represent all of the specialties and subspecialties and collaborate with full-time medical staff in the teaching responsibilities of the graduate medical education programs.