Revenue Accounting Director is responsible for the development and direction of revenue cycle management operations for the organization that optimize the patient financial interaction along the care continuum. Develops strategies to optimize operations and to ensure sufficient cash flow. Being a Revenue Accounting Director establishes targets, policies, and internal controls that will drive improvements and efficiencies in overall service revenue capture and collection. Ensures compliance with regulatory requirements and responsiveness to changes in requirements. Additionally, Revenue Accounting Director coordinates with stakeholders across the organization to drive optimal financial performance. Requires a bachelor's degree. May require Certified Public Accountant (CPA). Typically reports to the cfo or top management. The Revenue Accounting Director manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. To be a Revenue Accounting Director typically requires 8+ years of managerial experience. Comprehensive knowledge of the overall departmental function. (Copyright 2024 Salary.com)
Job Summary - Director, Revenue Integrity
The Director of Revenue Integrity directs the Revenue Integrity department and provides vision for the design, implementation and coordination of all services within Corewell Health. Accountable for revenue capture for all hospitals (Corewell Health East, West and South and Post-Acute) and Corewell Health Medical Group, to support the financial well-being of the organization. Collaborates with Clinical, Financial, Revenue Cycle, Information Services, leadership at all hospitals/medical group entities to ensure the accuracy and timeliness of charge capture. Directs the processes/staff that support operationalizing all hospital and/or professional services programs and services, for all hospitals, post-acute business lines, and/or professional services, on behalf of Finance/Revenue Cycle. Directs all Charge Integrity system support activities.
Essential Functions - Director, Revenue Integrity
Oversees development and implementation of pricing strategy and establishing prices for chargeable services for all Corewell Health. Coordinates annual chargemaster pricing defensibility studies to ensure rational, consistent, and transparent pricing. Coordinates external CDM-related regulatory audits to ensure that all information is available and completed on a timely basis.
Knowledge and understanding of all charge processes within the organization; provides oversight to staff who assist other department managers/directors with determining chargeable services and appropriate CPT/HCPCS coding. Ensures clinical department staff comply with established charge capture and charge reconciliation policies and procedures. Identifies and recommends opportunities for improved standardization and consistency of charge capture processes system wide.
Responsible for the build, testing, implementation and maintenance of Chargemaster within the Epic Resolute Hospital Billing application and Professional Fee Schedule. Actively participates in maintaining relative value unit (RVU) assignments and RVU conversion for professional charges to track physician productivity and payment.
Assesses revenue generating departments, particularly those that are high volume, high revenue, and/or high risk to ensure accurate charge capture and provides recommendations for revenue cycle process improvements.
Responsible for the development of system wide CDM integration and standardization between hospitals CDM master files. Responsible for researching Medicare Federal Regulations and Local Coverage Determinations for all service lines. Drafts summaries, billing protocols, and training tools as needed.
Keeps abreast of current regulatory information/guidelines and coaches' others to do the same; communicates relevant changes and/or protocol and procedural revisions to senior management and staff. Implements appropriate departmental operational changes to ensure compliance. Participates in industry meetings and workgroups.
Fosters teamwork and innovative thinking. Creates a spirit of teamwork and unity among department members that allows for sharing of ideas, debate and decision resolution. Builds an appreciation of diversity as well as cohesiveness, supportiveness, and working effectively together to enable each employee and the department to succeed.
Maintains and directs team of Charge Integrity professionals. Oversees the processes to establish, maintain and continuously update and monitor the accuracy of the charge master files a in various hospital, professional (fee schedule), and clinical systems, including oversight of annual CPT and quarterly HCPCS updates, compliance to state and federal billing / compliance regulations.
Qualifications - Director, Revenue Integrity
Required Bachelor's Degree in Healthcare, Finance, Accounting or related field.
Preferred Master's Degree.
10 years of relevant experience in Revenue Cycle Required.
5 years of relevant experience professional financial, reimbursement, or analysis experience Required.
1 year of relevant experience supervisory/management experience Preferred.
CDM build/maintenance experience Preferred.
CRT-Healthcare Financial Management Association (HFMA) Certification within 180 days hire required.
#LI-CH
Physical Demands
Primary Location
SITE - 4700 60th St - Grand RapidsDepartment Name
Revenue IntegrityEmployment Type
Full timeShift
Day (United States of America)Weekly Scheduled Hours
40Hours of Work
8 a.m. to 5 p.m.Days Worked
Monday to FridayWeekend Frequency
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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.