HCA, Hospital Corporation of America Director of Revenue Integrity in Arlington, Texas
TheRevenue Integrity Director is responsible for ensuring the accuracy of revenue capture and adherence to Company, regulatory and industry requirements. This position will work closely with Facility Departments and provide support and education when appropriate. This position will oversee charging policy and procedures, audits and monitoring programs and educational documents.
· Manage a staff of E/M compliance coordinators and nurse auditors.
· Manage and oversee observation charge capture process; to include med administration charges and appropriate status capture in Patient Accounting System.
· Conducts and participates in monthly staff meetings.
· Ensure that all hospital charges are captured and reported correctly in accordance with compliance and billing guidelines.
· Provide charging guidance and education on all new service lines.
· Serve as liaison for Parallon Revenue Integrity to conduct and complete facility requests to ensure timely billing.
· Maintain Chargemaster and ensure compliance for all revisions and additions. Ensure all SOX requirements are met.
· REGS/Billing communications - Ensure and track that all REGS communications are sent to appropriate Director to ensure adequate and timely education.
· Serve as facility RAC, Denial Management Team, and NCD/LCD Coordinator.
· Monitor monthly denial and write-off reports to assist in identifying trends and process breakdowns. Conduct education to reduce denials and write-offs.
· Settlement Requests - work with Shared Services to coordinate with CFO Settlement requests; work with CFO on patient requests for additional discounts.
· Administrative write offs - Monitor and get appropriate CFO approval on administrative write offs; reconcile Ambulance transport bills; coordinate all Professional discount request from physicians; monitor trauma level charging for appropriateness.
· Coordinate and lead the Facility Billing Integrity Committee and be an active participant of the Facility Ethics and Compliance Committee.
· Ensures staff maintain all required competencies and certifications, and evidence of these are provided in a timely manner.
· Provides constructive feedback and continually monitors employee performance. Ensures all staff are evaluated in a timely manner according to facility schedule.
· Maintains proper documentation in compliance with accreditation and regulatory agencies.
· Ensures all policies are current, updated and available for staff via the 360 Compliance tool.
· Bachelor’s Degree preferred
· Five (5) years billing integrity/patient accounts experience required
· Medical Terminology required
· Minimum two (2) years of experience with HCA Clinical and Billing systems preferred
Title: Director of Revenue Integrity
Location: Texas-Arlington-Medical Center of Arlington- Arlington (Dallas/Ft
Requisition ID: 00015-84092