Director, Revenue Cycle Regulatory Research

September 20

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SSM Health

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10,000+

💰 Debt Financing on 2019-11

Description

• Directs day to day activities of regulatory coordinators to ensure necessary regulatory updates are researched and assessed for departmental compliance. • Educates and informs revenue cycle departments of impending government or state regulations impacting revenue cycle, focusing on acute and ambulatory coding and billing. • Provides revenue regulatory guidance (coding/billing) to ensure compliant billing and coding practices. • Provides insight to potential changes proposed in efforts to proactively plan for operational changes. • Directs a coordinated regulatory research program for the organization. • 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. • Identifies and evaluates emerging compliance, coding, and financial risks, utilizing regulatory guidance, resources, and data analytics to educate and implement compliant practices. • Oversees written and verbal communication shared for education on regulatory and payor changes. • Ensures knowledge of Medicare IPPS and OPPS and state regulated payors (Medicaid) within regulatory coordinators is maintained to cascade to revenue cycle teams. • Influences revenue cycle operations and coding staff and provides operational guidance to leadership team. • Optimizes reimbursement and reduces compliance risks. • Serves as point of contact for revenue cycle compliance, coding, and regulatory initiatives. • Performs routine regulatory research and provides guidance on regulatory changes.

Requirements

• Bachelor's Degree • Seven years' experience, with five years in direct people management/leadership • Required Professional License and/or Certifications: Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician-based (CCS-P), Certified Healthcare Financial Professional (CHFP), Certified Outpatient Coder (COC), Certified Professional Coder (CPC®), Certified Revenue Cycle Representative (CRCR), Certified Specialist Accounting and Finance (CSAF), Certified Specialist Business Intelligence (CSBI), Certified Specialist Payment and Reimbursement (CSPR), Certified Specialist Physician Practice Management (CSPPM), Executive of Healthcare Revenue Cycle (EHRC), Fellow of the Healthcare Financial Management Association (FHFMA), Registered Health Information Administrator (RHIA), OR Registered Health Information Technician (RHIT)