The Director of Revenue Integrity is responsible for strategic activities related to front end Revenue Cycle operations for OHSU Health which includes OHSU and all of OHSU system partners both current and future. The operational functions under this positions oversight support compliant charge capture and optimal cash flow to the organization. Responsibilities include planning, organizing and directing daily routines related to provider and facility enrollment, Epic systems build, charge capture workflows, revenue cycle data analytics, inpatient and outpatient clinical documentation improvement and inpatient coding.
The Revenue Cycle Team, Client Service Analysts, PB Epic Project team and Revenue Cycle Integration teams are responsible for system wide implementation, support and maintenance of front end charge capture and cash collections workflows. The Provider Enrollment Team is responsible for OHSU Health facility and practitioner enrollment with payors and support of MACRA value based physician payments. The Client Service Analysts team is responsible for supporting School of Medicine departments as it relates to revenue cycle workflows and data analytics. The Inpatient Clinical Documentation Improvement team is high profile team that performs chart reviews to ensure providers are documenting appropriately to reflect the highest level of complexity of OHSU Health patients which results in optimal reimbursement. This position also oversees the inpatient coding team and the outpatient Hierarchical Condition Category (HCC) team, responsible for coding that assigns patients a risk adjustment factor (RAF) score.
The Director of Revenue Integrity is responsible for system oversight of Epic Resolute Application Build and master file maintenance including Epic DEP and SER, billing work queues, procedure code build and pricing for all OHSU Health patient care activities. Operational functions include accurate, compliant and timely charge capture workflows for new and existing OHSU Health business that follow CMS guidelines and ensures cash flow for the organization. This position ensures efficient operations of responsible departments and sets goals to ensure optimal staff performance. The Director of Revenue Integrity has a direct impact on gross patient revenue, cash collection and internal and external customer service.
The Director of Revenue Integrity will collaborate with OHSU Affiliates and Partners and assist with implementing new and expanded revenue cycle service lines as requested. This position is responsible for identifying, prioritizing and tracking status of all OHSU Health Revenue Cycle related project initiatives for report out to VP of Enterprise Revenue Cycle and CFO OHSU Healthcare.
This position reports to the VP of Enterprise Revenue Cycle and has oversite responsibilities for the staff and duties related to the functions described above to ensure smooth revenue cycle operations that meet the financial needs of OHSU Health.. The Director of Revenue Integrity will work with the VP to set strategic goals and system wide revenue cycle performance improvement initiatives to ensure smooth revenue cycle operations that meets the needs of OHSU Health financials and patient care.
The Revenue Integrity Director has direct responsibility of 8 teams and is responsible for budgeting and planning with an annual budget of $8.4M and 100 FTEs. This is an integral part of the revenue cycle directly affecting annual net patient revenue of $1.95B for FY20.
Bachelor degree in Business or related field, or equivalent combination of education and experience.
Minimum of ten years experience in revenue cycle operations.
A minimum of five years experience leading a revenue cycle/billing department in a health system or major hospital.
Demonstrated knowledge of all phases of patient accounting, operations, issues, challenges and performance metrics.
Demonstrated record of accomplishment in meeting performance hurdles for improving cash collections as well as hitting targets for net days in accounts receivable.
Record of performance in developing and sustaining performance accountability at all levels within the revenue ccle operations department.
Demonstrated knowledge of dealing with potentially complex managed care contracting issues with a record of success in effectively producing appropriate patient bills consistent with the contract.
Record of effective collaboration with other members of the revenue cycle team to ensure success in achieving hospital or system performance targets.
Track record for successfully making and effectively implementing tough decisions
Experience managing multiple operational teams.
Demonstrated understanding of coding and clinical documentation improvement operations.
Experience implementing lean process improvement efforts.
Exceptional leadership skills with a record of building a strong, results-oriented team that excels in a performance-driven environment.
To provide leadership that will achieve and sustain performance momentum.
A recognized problem-solver with a history of building a best-in-class department.
Executive presence with a sense of urgency with performance and process improvement.
Reputation for an attention to details and meeting deadlines with a superior work product.
Intellectual capacity to assess complicated processes and to devise creative solutions that will enhance performance.
Demonstrated consistent commitment to effective customer service.
Effective written and verbal communications skills.
Ability to work in a self-directed manner.
Demonstrated skills in effectively managing political issues and situations.
Demonstrated record of accomplishment in recruiting, retaining and developing managers and staff members.
CPAT (Certified Revenue Cycle Representative) and/or HFMA (Healthcare Financial Management) CRCR (Certified Revenue Cycle Representative) (within first year of employment).
Must be able to perform the essential functions of the position with or without accommodation.
Masters of Healthcare Administration preferred.
HFMA Certified Healthcare Financial Professional (CHFP).
Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or email@example.com.
As the state's only health and research university, OHSU brings together patient care, research, education of the next generation of health care providers and scientists and community service to improve the health and well-being of all Oregonians.The university is a conduit for learning for more than 2,800 students, providing training to interns, residents and fellows in postgraduate medical and research. It is the only place in Oregon that grants doctoral degrees in medicine, dentistry and nursing. OHSU cares for more than 251,000 patients each year from around the region and takes a leadership role in contributing to solutions involving the health of the state and the nation, such as health care access and transparency, ethics and workforce shortage. Beyond providing critical health care services, quality education and cutting-edge research, OHSU also is a key economic and social force in the Northwest. With an annual operating budget of $2.06 billion and more than 14,000 employees, OHSU is Portland?s largest employer. Its size contributes to its ability to provide... many services and community support activities not found anywhere else in Oregon. For more information visit http://www.ohsu.edu/xd/about/index.cfm