Revenue Integrity Audit Director Job

Full Job Title: Director Revenue Integrity Audit

Job Number: 17012306

Facility: Missouri-Richmond Heights-SSM Heart and Vascular at Clayton

Location: Richmond Heights, MO

Schedule: Full Time, Days

Hours: 8am-430pm


Role Purpose:
This is a leadership position that directs the Revenue Integrity team in its functions of supporting a healthy revenue cycle through auditing and identification of process improvement opportunities focused around the charging and reconciliation of the services provided to the patients of the STL region. This is a key revenue cycle position that assists in ensuring our clinical leaders and their staff have the information and tools needed to navigate the regulations of the STL revenue cycle and adjust to the changes to it. This position is responsible for engaging with and collaborating with all revenue cycle stakeholders.
    • Contributes to customer satisfaction by acting as liaison with facility and service line leadership
    • Interviews, hires, directs, develops, and evaluates direct reports.
    • With consultation from Human Resources, makes decisions on the discipline and/or discharge of direct reports.
    • Meets monthly with team's review policies, procedures and addresses concerns.
    • Coordinates audit staff schedule and processes to serve our internal and external customers, and to enhance clinical and financial operations.
    • Contributes to the overall financial performance of the St. Louis network by demonstrating process improvement, charge capture, charge reconciliation, compliance, and revenue enhancement and completion of all expectations to assist in reaching optimal reimbursement for the services provided in all St. Louis Network facilities
    • Coordinates all team projects which include but are not limited to process improvement, charge capture and reconciliation, compliance, and optimizing entitled net revenue.
    • Coordinates revenue integrity team approach to new services and service lines for the STL network
    • EPIC partner and representative to coordinate training for internal revenue integrity staff and support training for external charge entry staff
    • Embraces, engages, supports, and utilizes tools and vendors with network and system projects, processes and initiatives that enhance the capture of revenue and reimbursement.
    • Collaboration with PBS, HIM Coding, Chargemaster to address and resolve account issues at different stages of the revenue cycle.
    • Participation in system level meetings and projects on multidisciplinary revenue cycle opportunities as a representative for the STL Network.
    Minimum Requirements:
    • Minimum of 5 years of clinical experience or revenue cycle in a hospital setting; coding and auditing experience preferred
    • Bachelor's degree required
    • Certification in Nursing (RN, BSN) or Coding (CCS/RHIT/RHIA) required
    • High level analytical and problem solving skills, and strong leadership skills for a broad base of stakeholders
    Preferred Qualifications:
    • Master's degree preferred

SSM Health - System Office –

SSM Health is one of the largest Catholic health systems in the country and is dedicated to quality and compassionate care for anyone in need, regardless of ability to pay. Based in St. Louis, where its System Office is located, SSM Health operates 20 hospitals in Wisconsin, Illinois, Missouri and Oklahoma. We provide care in various settings: outpatient sites, physician offices, a pharmacy benefit company, an insurance plan, hospitals, nursing homes, home care, hospice, telehealth and a technology company.Our Mission: Through our exceptional health care services, we reveal the healing presence of God.

SSM Health is an Equal Opportunity and Affirmative Action Employer. Qualified applicants are considered for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected by law. Learn More »

Back to top