Director Revenue Integrity - Tucson Medical Center

SUMMARY:

Directs daily operations related to the development, maintenance, and configuration of Health Information Management (HIM) and Coding. Leads a team of HIM and coding professionals and collaborates with various departments to optimize revenue procedures. Works on complex health information and coding matters where analysis of issues, data and process require advanced specialist knowledge and in-depth industry and technical knowledge.

ESSENTIAL FUNCTIONS:

Responsible for all HIM and coding functions for all TMC Healthcare facilities.

Oversees health information and coding management with accountability for the attainment of enterprise goals and objectives, and the alignment of services to enterprise initiatives, mission, vision and value.

Standardizes and integrates practices across the enterprise.

Collaborates with a multitude of individuals and departments across the enterprise, including providers and key departments of patient financial services, revenue cycle, Information Technology (IT), privacy and compliance.

Organizes and streamlines operations to achieve financial and service objectives.

Participates in revenue cycle strategies and initiatives.

Demonstrates vision and leadership in strategic planning and manages multiple competing priorities and diverse viewpoints.

Leads by example, with initiative, self-discipline, confidence and professionalism to encourage and enable a management team and staff.

Analyzes existing paradigms and create streamlined processes.

Adheres to TMC organizational and department-specific safety, confidentiality, values, policies and standards.

Performs related duties as assigned.

MINIMUM QUALIFICATIONS

EDUCATION: Bachelors Degree from an accredited college or university.

EXPERIENCE: Seven (7) years of progressive management-level experience including five (5) years experience within an acute care hospital environment.

LICENSURE OR CERTIFICATION: Must have one of the following: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Clinical Documentation Specialist (CCDS) from ACDIS, Certified Documentation Improvement Practitioner (CDIP) from AHIMA, or current RN Licensure.

KNOWLEDGE, SKILLS AND ABILITIES:

Knowledge of ICD 10 and /or CPT/HCPCS coding

Must demonstrate a broad-based knowledge of coding, billing, and health information management practices.

Knowledge of regulatory requirements, payer regulations that impact charging, billing, and denial management.

Thorough knowledge of current practices, regulations, and techniques in access services.

Knowledge of building and supporting teams and collaborative workgroups.

Skill in conflict management.

Skill in strong verbal and written communications.

Skill in tactful interaction with providers regarding compliance best practice guidelines, utilization of hospital resources, documentation requirements, and other case management issues.

Strong analytical, assessment and problem solver.

Ability to present positive internal and external communication and effectively represent TMC care management.

Ability to identify external and internal changes and engage in responsive initiatives or actions both functionally and system wide.

Ability to effectively lead and work within teams.