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Cedars-Sinai Exec Dir, Compliance & Revenue Integrity in Los Angeles, California

Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We hire team members who are committed to improving patients' lives. We provide an outstanding benefit package, along with competitive compensation. Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals.

Job Summary:

The Executive Director, Compliance & Revenue Integrity is responsible for promoting the financial viability of the organization by effectively managing aspects of the revenue capture operations. Provides guidance and oversight for charge description master integrity, patient account charge audits, regulatory audits and appeals, underpayment recovery and denials management for the hospital and physician clinic services. Supports and manages the technical charge capture systems, processes and workflows of revenue generating departments for the organization to ensure timely and accurate recording of revenue, in accordance with all applicable governmental and institutional standards, bylaws, rules and regulations. Provides information to charge capture teams and operational directors/managers related to mechanisms of charge triggers, controls and reconciliation, and coding purposes of compliant billing and charging procedures.

Primary Duties and Responsibilities:

  • Oversees the implementation of programs, policies, initiatives, and tools for Charge Capture, including but not limited to institutional system-wide charge capture processes are handled with efficiency.

  • Develops policies and procedures, monitoring tools for late charges and establishment of procedures for timely and accurate charge capture mechanisms.

  • Develops and maintains collaborative working relationship with revenue producing departments, information systems personnel, technical and clinical personnel to identify chargeable activities, to establish charge capture mechanisms, and orderly and timely recording of revenue.

  • Collaborates with Clinical Physician Leaders and Departments to review new technologies and establish related charge capture and coding protocols.

  • Directs and facilitates the development of corrective action plans related to any deficiencies noted concerning charge capture effectiveness and system integration.

Education :

  • Bachelor's degree in Business Administration, Healthcare Administration and/or related field required

  • Master's degree in Business Administration, Healthcare Administration and/or related field preferred

Experience:

  • 12 years of relevant experience within Revenue Integrity required

  • 5 years of Management / Supervisory experience required

Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.

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