Revenue Integrity Director in Houston at Parallon

Date Posted: 8/17/2019

Job Snapshot

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  • Location:
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  • Experience:
    At least 5 year(s)
  • Date Posted:

Job Description

Job Summary –
The Revenue Integrity Director of a Parallon Business Performance Group Shared Services Center (SSC) is accountable for ensuring the integrity of the revenue for the facilities they serve. The Revenue Integrity Director has the responsibility to manage the department in an efficient, standardized and cost-effective manner that is consistent with the mission and values of Parallon Business Performance Group. The Revenue Integrity Director is responsible for setting the tone for the department and to ensure all RI staff understands that regulatory compliance takes precedence over all other initiatives.
The Revenue Integrity Director is responsible for the daily operations of all functions and oversight of the RI team members and serves as a liaison between the Revenue Integrity Department of the SSC and the facilities they serve. As the leader of the department, this person will serve as a key promoter of the SSC, which strives to meet and exceed the needs of its customers.
Supervise staff and organize the structure of the program and coordinate the transition process for staff to become affiliated with the SSC. Establish and maintain relationships with all customers, including: SSC executive staff, RI staff, hospital executive management teams, department directors and others. Consult with hospitals concerning daily operations and general management of their charging processes. This position will involve ensuring that standard approved educational programs are followed, allocating and assigning duties to employees, and monitoring the activities and operations to ensure all regulatory guidelines and 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.

Supervisor – SSC Front Office COO

Supervises – Revenue Integrity Manager, Revenue Integrity Team Leads, Revenue Integrity Analysts, Hospital Bill Audit Coordinator

Duties (included but not limited to):
• Primary oversight responsibility to ensure Revenue Integrity is following functional standards as outlined in the RI functional standards guidebook
• 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
• Establish and maintain relationships with all customers, including: SSC 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
• Ensure standard and approved educational programs are used to education RI staff and ancillary department, 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 for acquisitions
• Draft summary reports and make presentations to SSC Management Team, Division, Facility Leadership Teams and other staff during and post transition for acquisitions
• Review and make operational recommendations prior to, during and post transition for acquisitions
• Interpret and analyze AR Reports, such as, Bill 45, Bill 49, DET Reports across all facilities etc.
• Work diligently with SSC 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
• Establish controls and review mechanisms for SSC policies and procedures
• Develop specific objectives, budgets, and performance standards for each area of responsibility
• Identify and implement process improvements to lower costs and improve service to facility customers
• Assume a lead role for innovation, knowledge sharing and leading practices identification within the SSC and among peer group
• Perform staff reviews and prepare performance documents for director reports
• Practice and adhere to the "Code of Conduct" philosophy and "mission and Value Statement"
• Other duties as assigned

Job Requirements

Technical Expertise – Some understanding of healthcare including knowledge of healthcare terms and accounts receivable processes and basic payer rules, which affect reimbursement and/or compliance requirements
Strategic Analysis - Analytical Review skills and ability to make decisions based on analysis
  • Leadership - guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
Tactical execution - oversees the development, deployment and direction of complex programs and processes
Financial management - applies tools and processes to successfully manage to budget
Project Management - assesses work activities and allocates resources appropriately
Organization - proactively prioritizes needs and effectively manages resources
Communication - communicates clearly and concisely, verbally and in writing. This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately. The ability to communicate with staff, Parallon Management, Division and Group Executives
Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
Interpersonal skills - able to work effectively with other employees, patients and external parties
PC skills - demonstrates proficiency in Microsoft Office applications and others as required
Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
Operational Knowledge - Familiarity with daily operations of Revenue Cycle including understanding of front/back office operations, patient flow, and staff work assignments and integration of major components of the Revenue Cycle, including patient registration, coding, charging, managed care, cash management and billing.
Basic Skills – demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly. Spell correctly and transcribe accurately.

Bachelor’s Degree in Business or related field required.

Minimum 5 years healthcare management experience with three of these years in the related area for the position. Relevant education may substitute experience requirement with SSC Executive approval.