Cook County Health
EXECUTIVE DIRECTOR OF HIM CODING & REVENUE INTEGRITY - FINANCE
Cook County Health, Chicago, Illinois, United States
Job Title
Executive Director of HIM Coding & Revenue Integrity – Finance Job Summary
The Executive Director of HIM Coding & Revenue Integrity (ED) is responsible for managing and maintaining compliance with the rules and regulations pertaining to health information management (HIM), coding, charge description master (CDM) governance, charge capture, pricing strategies and policies for Cook County Health (CCH). The ED oversees health information management, coding, charge entry, CDM, and revenue integrity management, ensuring that it supports clinical practices and aligns with reporting requirements for government and major commercial third-party payers. The ED collaborates with internal and external stakeholders as needed to develop programs and/or functions to improve the integrity of system generated revenue. Responsibilities
Leads the HIM, coding, and revenue integrity operations and strategic initiatives for Cook County Health. Creates and executes strategic plans related to HIM coding and revenue integrity operations. Ensure CDM numbering conventions, CPT coding, description nomenclature, billable services, procedure/supply catalog development and updates for all CDM items are appropriate and verified through routine feedback from Business Office and clinical departments. Ensure annual pricing strategies are executed in accordance with policies and contracts. Review and design operational efficiencies to maximize market solutions. Review charge entry policies and procedures to ensure they are followed and KPI performance is achieved. Assess and process all requested additions, deactivations and other modifications to the CDM file and collaborate with department leadership on necessary charge capture changes. Collaborate with Information Technology (IT) to maintain and reconcile CDM updates. Determine audit schedules to identify potential issues and opportunities for improvement; monitor metrics to enhance performance. Create revenue cycle performance report sets for each revenue stream. Establish relationships with internal and external stakeholders, distribute monthly utilization statistics, and respond to ad hoc questions. Oversee revenue cycle master file maintenance (e.g., Physician Master File, Insurance Master File) and other related master files; maintain ongoing certification requirements. Report to the Chief Revenue Officer; perform other related duties as assigned. Minimum Qualifications
Bachelor’s degree from an accredited college or university (official transcript due at the time of interview). Minimum five (5) years of experience in revenue integrity, healthcare information management (HIM) and/or coding. Three (3) years of management and/or leadership experience. Minimum of two (2) years of experience in Cerner or Epic systems. Must have at least one of the following certifications: CRCR, CDC (AAPC), or CCS. Preferred Qualifications
Master’s degree (official transcript due at the time of interview). Minimum five (10) years with Health Information Management or Coding or CDM maintenance within a large hospital or healthcare system. CDC and/or CCS certifications preferred; HFMA or AHIMA affiliation preferred. Knowledge, Skills, Abilities And Other Characteristics
Knowledge of Windows-based software and hospital-specific accounting and billing software. Understanding of Federal, State, Local, and Agency healthcare laws, standards and financial regulations. Excellent verbal and written communication and interpersonal skills to engage with diverse staff and patient populations. Analytical, organizational, problem-solving, decision-making, critical thinking, and conflict management/resolution skills. Attention to detail, accuracy, and ability to meet deadlines; strong project management skills. Ability to train others and to adhere to department policies and standards using best practices. Physical and Environmental Demands
This position operates in a healthcare environment and requires adherence to hospital and department safety policies, including PPE, hand hygiene, and standard safety practices. Benefits
Medical, dental, and vision coverage Basic term life insurance Pension plan Deferred compensation program Paid holidays, vacation, and sick time Public Service Loan Forgiveness (PSLF) eligibility may apply Additional Information
COOK COUNTY HEALTH AND HOSPITALS SYSTEM is an equal opportunity employer.
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Executive Director of HIM Coding & Revenue Integrity – Finance Job Summary
The Executive Director of HIM Coding & Revenue Integrity (ED) is responsible for managing and maintaining compliance with the rules and regulations pertaining to health information management (HIM), coding, charge description master (CDM) governance, charge capture, pricing strategies and policies for Cook County Health (CCH). The ED oversees health information management, coding, charge entry, CDM, and revenue integrity management, ensuring that it supports clinical practices and aligns with reporting requirements for government and major commercial third-party payers. The ED collaborates with internal and external stakeholders as needed to develop programs and/or functions to improve the integrity of system generated revenue. Responsibilities
Leads the HIM, coding, and revenue integrity operations and strategic initiatives for Cook County Health. Creates and executes strategic plans related to HIM coding and revenue integrity operations. Ensure CDM numbering conventions, CPT coding, description nomenclature, billable services, procedure/supply catalog development and updates for all CDM items are appropriate and verified through routine feedback from Business Office and clinical departments. Ensure annual pricing strategies are executed in accordance with policies and contracts. Review and design operational efficiencies to maximize market solutions. Review charge entry policies and procedures to ensure they are followed and KPI performance is achieved. Assess and process all requested additions, deactivations and other modifications to the CDM file and collaborate with department leadership on necessary charge capture changes. Collaborate with Information Technology (IT) to maintain and reconcile CDM updates. Determine audit schedules to identify potential issues and opportunities for improvement; monitor metrics to enhance performance. Create revenue cycle performance report sets for each revenue stream. Establish relationships with internal and external stakeholders, distribute monthly utilization statistics, and respond to ad hoc questions. Oversee revenue cycle master file maintenance (e.g., Physician Master File, Insurance Master File) and other related master files; maintain ongoing certification requirements. Report to the Chief Revenue Officer; perform other related duties as assigned. Minimum Qualifications
Bachelor’s degree from an accredited college or university (official transcript due at the time of interview). Minimum five (5) years of experience in revenue integrity, healthcare information management (HIM) and/or coding. Three (3) years of management and/or leadership experience. Minimum of two (2) years of experience in Cerner or Epic systems. Must have at least one of the following certifications: CRCR, CDC (AAPC), or CCS. Preferred Qualifications
Master’s degree (official transcript due at the time of interview). Minimum five (10) years with Health Information Management or Coding or CDM maintenance within a large hospital or healthcare system. CDC and/or CCS certifications preferred; HFMA or AHIMA affiliation preferred. Knowledge, Skills, Abilities And Other Characteristics
Knowledge of Windows-based software and hospital-specific accounting and billing software. Understanding of Federal, State, Local, and Agency healthcare laws, standards and financial regulations. Excellent verbal and written communication and interpersonal skills to engage with diverse staff and patient populations. Analytical, organizational, problem-solving, decision-making, critical thinking, and conflict management/resolution skills. Attention to detail, accuracy, and ability to meet deadlines; strong project management skills. Ability to train others and to adhere to department policies and standards using best practices. Physical and Environmental Demands
This position operates in a healthcare environment and requires adherence to hospital and department safety policies, including PPE, hand hygiene, and standard safety practices. Benefits
Medical, dental, and vision coverage Basic term life insurance Pension plan Deferred compensation program Paid holidays, vacation, and sick time Public Service Loan Forgiveness (PSLF) eligibility may apply Additional Information
COOK COUNTY HEALTH AND HOSPITALS SYSTEM is an equal opportunity employer.
#J-18808-Ljbffr