Middle Revenue Services Senior Director

Building Location:

Business Service Center

Department:

1006000 REVENUE CYCLE ADMIN - EH SS

Job Description:

Reporting directly to the Senior Vice President of Revenue Cycle, the Middle Revenue Services Senior Director is responsible for the leadership, direction, strategic development, implementation, and sustainment of programs and processes to lead coding, clinical documentation integrity, utilization management, health information management and revenue integrity.

The Senior Director uses their deep knowledge of industry best practices and extensive experience to partner with physician leaders and stakeholders to develop organization-level roadmaps of process and technology improvements to reduce provider burden and maximize patient experience while increasing efficiency. The Senior Director provides overall strategic direction to the Middle Revenue Services teams across the health system, centered on improving accuracy, optimizing revenue, and creating efficiencies.

Education Qualifications:

Key Responsibilities:

• Develops policies and procedures across the system for greater efficiency, reduced variation and increased patient satisfaction
• Promotes industry best practices and point-of-service (POS) tools, techniques, and measurements
• Serves as a coding, CDI, HIM subject matter expert for the system, serving on an array of business operations and clinical committees
• Develops and manages key performance indicators and metrics and adherence to fiscal targets
• Develops and oversees a comprehensive quality assurance and productivity program for all staff
• Collaborates with physician and operational leadership to optimize workflows and technology
• Demonstrates in-depth working knowledge of ICD, CPT, HCCs, MS-DRGs and APR-DRGs code classifications/groupers with the ability to analyze and trend key metrics including CMI
• Directs instructions and education activities for all providers and clinicians across the system, in collaboration with key stakeholders. Promotes compliance with CMS, third party payers, NCDs and LCDs, coding, and billing regulations. Oversees the development and coordination of ongoing education for new staff, including physicians, clinicians and coders.
• Provides input to coding and medical record documentation guidelines to assure compatibility and compliance with all regulatory, third party and organization policies
• Provides input to the direction for the establishment and maintenance of documentation standards, policies, and procedures
• Oversees and manages coding denial management activities

Educational Requirements:

• Bachelor’s degree in business, healthcare administration, health information, finance or related field

Required Qualifications:

• 5 years of mid-cycle operational experience
• 10 years of multi-hospital system management responsibility, including operations redesign and project management
• Knowledge of Federal/State/Commercial Insurance/Payers requirements

Preferred Qualifications:

• Master’s degree in Business, Healthcare Administration, Health Information, or Finance
• EPIC system experience
• 3M and Computer Assisted Coding experience
• Strong analytical, assessment and critical-thinking skills

Licensure/Certification Qualifications:

Certification/Licensure Requirements:

• AHIMA RHIA (Registered Health Information Administrator) or
• AHIMA RHIT (Registered Health Information Technician) or
• AHIMA CCS (Certified Coding Specialist)
  
   

This position is open to candidates authorized to work in the United States, with the exception of residents in the following states: California, Massachusetts, New Jersey, New York, Oregon, and Washington. Due to current employment policies, Essentia Health is not able to offer remote employment to individuals residing in these locations.

FTE: