Compliance Revenue Integrity Officer
CurrentResponsible for providing leadership and direction to achieve ongoing revenue related compliance while focusing on risk, requirements, quality, productivity and operational efficiency. Sets the strategic direction for the SRAlab compliance revenue integrity function. Provides direction, guidance, communication and education on coding and billing requirements, related risks and revenue opportunities while ensuring compliance and integrity with requirements. Collaborates with Operations… Show more Responsible for providing leadership and direction to achieve ongoing revenue related compliance while focusing on risk, requirements, quality, productivity and operational efficiency. Sets the strategic direction for the SRAlab compliance revenue integrity function. Provides direction, guidance, communication and education on coding and billing requirements, related risks and revenue opportunities while ensuring compliance and integrity with requirements. Collaborates with Operations, Information Technology (IT), Finance, and Revenue Cycle leadership to set the strategic direction for the compliance revenue integrity function. Demonstrates and applies knowledge of various payment and coding systems, particularly the Outpatient Prospective Payment System (OPPS), CMGs, HCPCS and CPT-4 coding schemes. Provides oversight of all governmental and payor audits and ensures that appeals are carried through. Assists in daily management, tracking and communication of audit and appeal activities. Develops and implements an annual educational plan regarding revenue integrity in line with strategic initiatives, risks, and revenue growth opportunities. Partners with the Physician Practice, HIM, Revenue Cycle and Managed Care on educating Operations and others on upcoming, revised and/or new revenue integrity related requirements. Show less
