Mkt Director Revenue Cycle Revenue Integrity-AR KY TNGA

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

As our Market Director, Revenue Integrity, you will oversee all revenue integrity activities, including reporting, auditing, reconciliation, denials management, and CDM (Charge Description Master) maintenance for assigned markets.

Every day you will supervise Market Manager(s), lead all market RI initiatives, monitor and approve CDM/fee schedule changes, and develop strategies to optimize revenue while ensuring compliance. You will also manage value capture programs, perform root cause analysis, foster cross-departmental partnerships, educate staff, and work closely with the Market CFO to maximize charge efficiency and implement system initiatives.

To be successful in this role, you will demonstrate strong leadership in revenue integrity, expert knowledge of CDM management and regulatory compliance, and a proven ability to optimize revenue generation through strategic and analytical approaches.

• Support facilitates annual CDM pricing review in alignment with Finance and Reimbursement policies and guidelines and serves as a point of contact for strategic pricing vendors.
• Maintains knowledge of and adherence to code of conduct standards, confidentiality agreements, and the organization-wide mission statement
• Review and analysis of all CDM/RI operations and financial reports
• Ensure best practice operations and process flows are being adhered to and recommend changes as necessary
• Alert System Director to any issues or potential issues as it pertains to performance from any vendor support currently being utilized
• Support the charge capture process to promote its accuracy and integrity across selected departments of the organization

Required

• Bachelors Other in healthcare administration, finance, business administration or related field
• 10+ years Ten (10) years’ experience in healthcare related revenue cycle functions, including coding and billing guidelines