Revenue Cycle Director
Job description
Analyze and resolve billing edits that require clinical expertise and are holding patient claims from billing, by reviewing medical records and other applicable documentation.
Maintain the integrity of facility Charge Description Master (CDM) and Revenue Integrity Systems Program by incorporating new charges and services identified by the departments, third party changes, special requirements, and/or coding updates.
Maintain the integrity of all Ancillary Department systems related to billing and revenue.
Identify charging, coding, or clinical documentation issues and work with ancillary departments to resolve issues and notify appropriate leadership.
Review, develop, implement, evaluate, and revise charge guidelines to optimize revenue management; effectively implement recommendations and monitors results.
Serve as liaison between Administration, the PAS and Ancillary Department Directors regarding revenue and compliance issues.
Coordinate all retrospective, concurrent, patient complaint and external billing audits and provide monthly audit results. Reviews all Medicaid, Medicare/CAHABA Billing Compliance correspondence and adheres to all guidelines.
Develop and coordinate educational in-services to the Business Office staff and Ancillary staff related to charging and billing issues.
Review denial trends for documentation or charging issue opportunities.
Review high charge stays/procedures for charging accuracy.
Ensure unbilled items are addressed properly and timely.
Computer skills: navigation and edit resolution through various Web based systems, Ability to use email, Excel, Word.
Knowledge of CPT, HCPCS, ICD-9 coding.
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