Director of Revenue Integrity
Aspen Valley Hospital
Glenwood Springs, CO
Glenwood Springs, CO, US
Glenwood Springs, CO
4 days ago
Embrace the adventure of a career at Aspen Valley Hospital. Aspen Valley Hospital is a twenty-five-bed community hospital that represents the best of two worlds - the warmth and friendliness of a small town and the technical expertise of a major medical center. Our award-winning hospital, nestled in the heart of Aspen, CO, includes a team of more than 500 people dedicated to making a difference for our patients, families, and community. Nationally we are recognized for providing some of the most exceptional patient care of any hospital across the country.
AVH supports vaccinations as the evidence-based and most effective means for our community and country to put COVID-19 behind us and to avoid unnecessary hospitalizations and deaths. In order to better care for our community, as of 10/31/21, AVH requires COVID-19 Vaccination for all Staff.
This Position Offers:
Highly competitive pay, 40 hours per week, comprehensive benefits package (including generous PTO, health insurance within your first 30 days, retirement), being part of a very cohesive & supportive team, and four of North America's top ski resorts at your doorstep.
Manages revenue integrity for all entities (hospital, freestanding physician practices, imaging center including client billing) which includes different applications, products, merchants, compliance and charge description masters.
Primary Scope of Responsibilities:
- Manages revenue integrity for all entities (hospital, freestanding physician practices, imaging center including client billing) which includes different applications, products, merchants, compliance and charge description masters.
- Manages patient inquiries that have been forwarded by MedAssist for assistance.
- Works with appropriate hospital personnel to ensure maximum charge capture at the point of service.
- Manages compliance with all Governmental Accounting Board, CMS regulations and third-party contracts to ensure integrity of recognized revenue through charge entry.
- Manages all departments' charge description masters along with concurrent and annual updates to ensure such updates will optimize reimbursement while complying with all federal and state regulations.
- Manages compliance with all third-party contracts regarding reimbursement, policy updates and physician credentialing to ensure reimbursement integrity (includes enforcement of compliance with third-party contracts and negotiating favorable terms for the hospital).
- Ensures that claim production through MedAssist meets all payer requirements, and is accurate and timely, and minimizes payer denials.
- Ensures claim detail integrity between AVH and MedAssist systems.
- Member of the grievances committee.
- Works with Chief Financial Officer to resolve all high-level patient account concerns and inquiries.
- Manages the Epic implementation related to the Revenue Cycle functions and partners with the Controller to ensure a smooth implementation of the Finance function with minimal impact to the Revenue Integrity function.
- Manage the outstanding accounts receivable in the previous EMR for the hospital and other related entities.
- Manages all financial assistance and reimbursement programs including Colorado Indigent Care, Charity, Planned Parenthood, Community Health, Plastics among others.
- Works closely with Medical Records Director to ensure timely and accurate coding of accounts and audit compliance and their resolution.
- Personnel Management - Manage staffing, including recruitment, supervision, scheduling, development, evaluation, and disciplinary actions.
- Fiscal Responsibility - Develop business case justifications and cost/benefit analyses for Department spending and initiatives. Develop and review budget for department and ensure it complies with stated goals, guidelines, and objectives.
- Regulatory & Accreditation Compliance - Develop and implement all Department policies and procedures.
- Staff Development - Ensure that staff members are aligned with department and organizational goals. Provide continued educational opportunities to support those goals.
- Departmental Quality & Performance Improvement - Develop and implement strategies to continually improve quality and performance of the department as it relates to the mission and goals of the organization
Minimum Qualifications & Requirements:
- Minimum of 5 years (recent) managerial experience in a hospital setting overseeing the Revenue Cycle and Integrity processes is required.
- Degree in business or other related field preferred.
Benefits & Compensation:
Hire-in rates of pay are based upon the relevance of years of experience, education and certifications. Our talent acquisition team will help you understand how your direct experience will be considered.
Pay range for new hires: $46.11 - $59.91/hr
Our comprehensive benefits package includes generous paid time off, health insurance within your first 30 days, and retirement can be viewed here.