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Job Description

Business Unit: Rush Medical Center

Hospital: Rush University Medical Center

Department: Revenue Cycle Revenue Integrit

**Work Type:** Full Time (Total FTE between 0.9 and 1.0)

**Shift:** Shift 1

**Work Schedule:** 8 Hr (7:00:00 AM - 3:00:00 PM)

Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits).

**Pay Range:** $63.10 - $106.01 per hour

Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Summary:

The system revenue integrity director, working in a remote environment, will lead all Rush revenue integrity initiatives and processes, promoting accuracy and appropriate reimbursement, health system wide. Ensuring effective operations, collaboration, strategic planning and driving results will be marks of success in this position. This leader promotes a positive culture, efficiency and the use of Epic automation and ancillary coding software solutions along with exemplifying the Rush mission, vision and values and act in accordance with Rush policies and procedures.

Other information:

Required Job Qualifications:

• Bachelor’s degree in health information technology, nursing, business, healthcare management, or other related fields

• AHIMA or AAPC Certification (such as CCS, CCA, CPC, COC, CPMA, RHIT or RHIA)

• Five years of experience in coding, charging, clinical care or a combination there-of

• Experience with Epic reporting and dashboards

• Demonstrated ability to communicate clearly and effectively

• Proficient in Microsoft Office, Excel, PowerPoint, and Word skills

• Strong interpersonal skills necessary for the communication and training of Revenue Integrity concepts

• Ability to perform multiple tasks with excellent time management skills

Preferred Job Qualifications:

Epic Certified

Master’s degree

Physical Demands:

**Disclaimer:** The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

Responsibilities:

1. Lead and direct revenue integrity staff while acting as a resource for the team’s work of connecting the Epic work queue edits, revenue codes, modifiers, ICD-10, CPT/HCPCS, and other codes, with clinical care, clinical documentation, and other parts of the business to ensure accuracy.

2. Improve revenue results and ensure adherence to federal state and payor regulations while driving compliance by ensuring the team has accurate work, optimizing the Epic automation functionality, charging and coding regulations are applied, and the middle revenue cycle initiatives are carried out per the revenue cycle goals and KPI’s

3. Work collaboratively with departments where charging/pricing are derived from complex systems and interfaces along with other revenue cycle departments that create charges.

4. Oversee Epic work queues including unbilled, claim edit, account, and ensure appropriate staffing levels to meet KPI’s and metrics.

5. Keeps abreast of changing industry and regulatory requirements and communicates changes to impacted leaders, staff, while collaborating with other areas and Epic for coding, reimbursement, quality, or clinical documentation issues, to solve, maintain a record of issues, and communicate solutions and improvements

6. Ensures timely charging practices are adhered to in operational areas.

7. Identify trends and lead performance improvement efforts through multi-disciplinary teams to streamline processes, enhance coding automation, prevent denials, train staff, ensure timely claims submission, and promote accuracy using short-term and long-term planning.

8. Oversee internal revenue integrity reviews and quality assurance to ensure compliance with CPT, HCPCS, and ICD-10 coding standards along with clinical care being charged appropriately.

9. Monitor industry trends, denial trends, and documentation patterns to inform training needs and process enhancements

10. Partner with Revenue Cycle leaders to track and positively impact KPI’s and revenue impact related to coding accuracy and compliance

11. Collaborate with Epic D&IS teams and ancillary software vendors to optimize documentation workflows and ensure efficient coding.

12. Develop, update and implement job standards, job duties, job aids, departmental policies, and performance appraisals for all areas of responsibility. Engages in development and growth of self and the team

13. Collect, interpret, and communicate performance data using various tools and systems, while also using this data to make decisions on how to achieve performance and budgetary goals

14. Responsible for interviewing, hiring, orienting new team members (staff & temp), staffing, performance management and development of staff. Counsel and disciplines employees, when necessary, in accordance with department and/or organizational policies. Maintains staff schedules, timecards, and payroll with fiscal responsibility.

15. Prepares monthly analytics reports, dashboards information, and other statistics along with forecasting, strategic planning, and budgeting.

16. Facilitate a positive culture that exemplifies growth-minded practices, leadership, and industry-best practices

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

**Position** Sys Dir Revenue Integrity

**Location** US:IL:Chicago

**Req ID** 22639