Director of Revenue Integrity

Our client, a not-for-profit teaching hospital serving an ethnically diverse community in New York City, is hiring a Manager of Revenue Integrity who will be responsible for overseeing and enhancing the hospital's revenue cycle management processes to ensure maximum reimbursement, regulatory compliance, and operational efficiency.

This leadership role involves strategic planning, policy development, staff management, and collaboration with multiple departments to optimize financial performance and ensure the integrity of revenue operations.

Key Responsibilities :

• Strategic Leadership :
• Develop and implement comprehensive revenue integrity strategies aligned with the hospital’s financial goals.
• Lead initiatives to improve revenue capture, reduce denials, and enhance overall revenue cycle efficiency.
• Provide strategic direction and oversight for revenue integrity operations and staff.
• Revenue Cycle Optimization :
• Oversee the entire revenue cycle, ensuring efficient processes from patient registration to final payment.
• Implement best practices for accurate billing, coding, and charge capture.
• Monitor key performance indicators (KPIs) and benchmarks to assess and improve revenue cycle performance.
• Regulatory Compliance :
• Ensure all revenue-related activities comply with federal, state, and local regulations.
• Stay abreast of changes in healthcare laws, payer requirements, and industry standards.
• Conduct regular audits to ensure compliance and identify opportunities for improvement.
• Data Analysis and Reporting :
• Analyze revenue cycle data to identify trends, gaps, and areas for improvement.
• Prepare and present comprehensive reports to senior leadership on revenue integrity performance.
• Use data-driven insights to make informed decisions and forecast future revenue trends.
• Denials Management :
• Develop and implement strategies to manage and reduce claim denials.
• Analyze denial patterns and collaborate with departments to address root causes.
• Oversee the appeals process to ensure timely and successful resolution of denied claims.
• Process Improvement :
• Lead continuous improvement initiatives to streamline revenue cycle processes and enhance efficiency.
• Collaborate with clinical, administrative, and IT teams to implement process improvements and technology solutions.
• Foster a culture of innovation and continuous learning within the revenue integrity team.
• Staff Leadership and Development :
• Recruit, train, and mentor revenue integrity staff, fostering professional growth and development.
• Ensure the team is well-versed in current regulations, billing practices, and technology tools.
• Promote a collaborative and high-performance work environment.
• Technology and Systems Management :
• Oversee the use and optimization of revenue cycle management software and electronic health records (EHR) systems.
• Evaluate and implement new technologies to support revenue integrity goals.
• Ensure data security and integrity within all revenue-related systems. Requirements :
• Bachelor’s degree in healthcare administration, business administration, finance, or a related field. A master’s degree is preferred.
• 7+ years of experience in healthcare revenue cycle management, with at least 5 years in a revenue integrity leadership role.
• Certification in Healthcare Revenue Integrity (CHRI), Certified Coder or similar certification is preferred.
• Extensive knowledge of healthcare billing, coding, and revenue cycle practices.
• Strong understanding of healthcare regulations and compliance requirements.
• Excellent analytical, problem-solving, and decision-making skills.
• Proficient in revenue cycle management software and EHR systems.
• Strong leadership, team management, and communication skills.
• Ability to collaborate effectively with cross-functional teams.

Salary : The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range.

Contact us for more information.

If you are passionate about what you could accomplish in this role, we would love to hear from you!

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