Under the direction of the Sr. Revenue Integrity Director, this position is responsible for acute and ambulatory clinical, coding and regulatory research. Identify and evaluate emerging compliance, coding and financial risks, utilizing regulatory guidance, resources, and data analytics on an ongoing basis to educate and implement leading regulatory compliant practices.
Leads, directs and influences revenue cycle operations and coding staff and provides operational efficiency and accuracy in coding and charging, helps optimize reimbursement and reduces compliance risks.
Directs a coordinated regulatory research program for Banner Health. Actively participates as a regulatory resource for the revenue cycle. Works to resolve regulatory compliance, coding and billing issues timely and facilitates communication of regulatory related matters.
Serves as point of contact for internal/external revenue cycle compliance, coding and financial regulatory initiatives.
Routinely performs regulatory research and provides guidance to the revenue cycle partners on regulatory changes, or in response to requests for interpretive guidance on billing or regulatory concerns.
Promotes consistency in coding audit and regulatory education process for all Banner Health employed physicians, advanced practice professionals and coders.
Develops and maintain a multidisciplinary team to evaluate CMS, government and commercial regulatory initiatives to evaluate for systemic concerns or necessary process changes.
Defines departmental goals and objectives providing leadership and guidance in selection, training, motivation and professional development of subordinate compliance professionals, and performs department managerial functions.
Must possess a strong knowledge and understanding of coding, billing and financial regulatory impacts obtained through the completion of a bachelors degree in Health Information Management, related field or work experience.
Requires knowledge of acute/ambulatory coding, regulatory research and education 5-7 years of operational experience in acute care of ambulatory coding management. Requires demonstrated ability to recognize opportunities for creating operational efficiencies. Requires excellent written and oral communication skills, as well as effective human relations skills for building and maintaining a working relationship with all levels of staff, physicians, and other contacts. This includes demonstrating strong influential and negotiation skills in a highly complex, matrix reporting organization.
Must have excellent analytical and data interpretation skills and proficiency in database and spreadsheet software.
Additional related education and/or experience preferred.
Internal Number: 253784
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.