REVENUE CYCLE COMPLIANCE EXECUTIVE DIRECTOR

DIRECT HIRE/REMOTE

SACRAMENTO

190,000K – 210,000K

Excellent opportunity to join a nationally ranked hospital.  Our Client offers exceptional employment benefits including medical, dental, and vision plans, generous paid vacations and holidays, excellent retirement savings and investment plans, continuing education, and reduced fee and scholarship programs.  This is a remote, direct hire position.

Responsibilities

This position plays a key role in implementing, monitoring, and enforcing company policy with the goal of minimizing risks associated with all aspects of billing as one method of preventing and detecting inappropriate, improper, and fraudulent conduct. In addition to managing a portfolio of compliance audits and investigations, the incumbent directs the workflow and performance of senior compliance and regulatory analysts, as well as coding and billing auditors and the manager. Additionally, this position requires the ability to function with autonomy demonstrating sound judgment and discretion.

Required Qualifications

Applicants are encouraged to upload license and certification if required of the position.

• Must posses and maintain certification in professional or facility documentation, coding and billing or both (i.e. CPC, CPC-H, or equivalent)
• Bachelor’s Degree in Health Care, Business or Finance or equivalent experience/training
• Extensive years of experience performing billing audits and/or quality control audits
• Extensive years of leadership/management experience
• Experience with and knowledge of instructional notations and conventions of ICD-9 CM, CPT, HCPCS classification systems; and ability to follow the detailed guidelines related to their use in assigning single, and sequencing multiple, diagnosis and procedure codes for appropriate reimbursements and data collection
• Experience to independently and effectively conduct revenue cycle investigations, including under attorney client privilege, if indicated
• Experience in writing investigation reports, agreements, charge documents
• Skills to interpret complex data and prepare comprehensive reports utilizing complex analysis specific to the appropriate project
• Proficient with medical terminology at college level with the ability to understand disease processes, anatomy, and physiology necessary for assigning accurate numeric and alphanumeric codes
• Presentation skills to organize media methods for education and training to faculty, staff, Department and Division
• Knowledge of and experience with billing and claims processing to effectively carry out compliance monitoring and audit functions
• Demonstrated interviewing skills to gain confidence and cooperation of interviewees, and the skill to draw out information, interpret responses and discover relevant facts
• Demonstrate excellent writing skills and experience in preparing reports, agreements, charge documents, corrective action, correspondence, proposals, policies and procedures, and other important employment documents
• Knowledge of and skills to interpret federal, and state laws, regulations, directives, and other relevant resources to effectively apply requirements to billing, documentation, privacy, and security requirements.
• Demonstrate skill and experience in analytical writing to produce accurate, useful reports and summaries to edit copy for correct grammar, spelling, and punctuation
• Extraordinary tact, diplomacy, discretion, professionalism, and judgment in the exercise of decision making and higher-level communications
• Executive level speaking and listening skills
• Ability to demonstrate skills in conveying facts, analyses, conclusions and recommendations in a clear, concise manner
• Ability to work effectively with diverse populations at all levels of the organization, including faculty, senior administrators, legal representatives, Office of the President Personnel, and external agency representatives

Preferred Qualifications

• CHC
• Auditing Certification
• Master’s in Health Care, Business, or Finance
• Juris Doctorate or other Doctorate Degree