Director, Revenue Integrity

City / State

Virginia Beach, VA

Work Shift

First (Days)

Overview : 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

Experience

Benefits : Caring For Your Family and Your Career

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission "to improve health every day," this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states :

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.