Overview
The Revenue Integrity Director leads a high-profile group responsible for ongoing maintenance and development of the charge description master (CDM) for all Sentara hospital facilities as well as Sentara Physician Groups, and charge capture structures/methodologies in Epic. Ensures that all items on the CDM are a direct reflection of chargeable/billable services. This role requires a comprehensive understanding of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) guidelines and Medicare regulatory guidelines, as well as the understanding of Epic build and its related charge capture processes.
This role supports internal coding and charge audit functions and provides oversight to the responses for governmental audits such as HRSA and Third-Party Payer audits, participating in compliance related activities and clinical denial root cause analysis and process improvements.
Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills combined with superb analytic and organizational abilities. The ability to meet deadlines while influencing but not directly managing the work of others is necessary.
Education
• Bachelor’s degree or equivalent.
• 10+ years' experience required
Certification/Licensure
- n/a
Experience
- 10 years relevant experience without a degree.
- 5 years leadership experience.