Director of Revenue Auditing

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Job description

Overview:

Bancroft is a leading service-provider for children and adults with autism, other intellectual or developmental disabilities, and those in need of neurological rehabilitation. We provide a full continuum of highly effective services, including special education schools, vocational training, day and residential programs, both on-campus and in the community, and in-home and outpatient rehabilitation services. We provide services in New Jersey, Pennsylvania and Delaware. As a nonprofit organization, we are solely committed to supporting people with special needs and their families, and strongly embrace diversity, equity and inclusion as part of our commitment to One World. For Everyone.

We are seeking a Director of Director of Revenue Auditing to support our Finance team in Cherry Hill, NJ!

Responsibilities:
The Director of Revenue Auditing is responsible for auditing complete, correct, timely and compliant charge capture initiatives and processes in the organization including in the Electronic Health Record. The Director of Revenue Auditing is responsible for reviewing and interpreting managed care contracts, government fee schedules and regulations to ensure appropriate reimbursement and documentation standards. The Director of Revenue Auditing ensures that all departments and programs in Bancroft are in compliance with regulatory documentation and coding standards.

Conducts audits and reviews activities to improve revenue cycle, claims production, and coding integrity. As part of the audit process, may review medical records and modifiers to determine if accurate following Medicare and National Correct Coding Initiative (NCCI). Based on the results of these audits, conducts targeted reviews of data and systems to identify areas for improvement.

Maintains knowledge of and organizational compliance with state, federal, and other third-party payer billing and reimbursement guidelines.

Provides guidance and education to billing and clinical department staff related to appropriate documentation requirements, denials resolution, and regulatory requirements relevant to charging, coding, and billing.

Compiles and analyzes data from various sources to develop recommendations leading to potential revenue cycle opportunities including, but not limited to, analyses related to CDM set-up, charge capture, billing, and patient financial services as a function or result of audits. May advise regarding processes to improve workflow while maintaining compliance with payer requirements.

Conducts root-cause analyses to identify opportunities for error reduction.

Implements charge capture corrective measures and monitoring tools to ensure sustainability of changes; performs, reviews, and monitors statistics and key performance indicators to identify improvement opportunities.

Identifies documentation risk areas and develops formal audit reports.

Reviews the compliance work plan and makes recommendations including, but not limited to, frequency of audits, annual risk assessments, and audit findings.

Prepares summary reports for the Executive Compliance Committee and the Board Compliance, Audit, and Enterprise Risk Committee as needed.

Supports the organizational leadership by developing coding and documentation educational and training programs to comply with applicable federal and state laws.

Serves as a subject matter expert and in a consultative role to various stakeholders.

Works collaboratively with stakeholders. Revenue Integrity Auditor 2 Effective May 2024

Demonstrates the highest level of confidentiality and conducts themselves according to AHIMA Code of Ethics.

Abides by the Bancroft's Mission Statement, Vision Statement, Core Values, Philosophy of Care and Code of Ethics in promoting behavioral norms, establishing relationships and providing guidance in decision-making situations.

Remains current with required training certifications, meets state-regulated licensing and regulatory accreditations, and adheres to mandatory requirements.

Performs other duties as assigned.

Qualifications:
Education & Experience:

Bachelor's degree from an accredited college in accounting, finance, or healthcare administration. Minimum of five years of revenue cycle management and/or revenue integrity experience in a healthcare environment. Working with people with intellectual/developmental disabilities and/or audit experience in healthcare is highly desirable.

What You'll Love About Bancroft:

Meaningful Purpose: We truly make a difference in the lives of others, which inspires us to be better people, and gives us purpose.

Lasting Bonds: We are a close-knit, committed team who feel like a second family

Personal Growth: There are opportunities to learn and build skills, professional development, career advancement, tuition assistance, and loan repayment programs

Outstanding Benefits: We offer competitive salaries, retirement savings program, generous paid time off, medical and dental insurance, and more

EEO Statement:
Bancroft is an Equal Opportunity Employer, and supports diversity, equity and inclusion in its hiring and employment practices, so that every team member can feel a true sense of belonging, and maximize their unique potential. To this end, all applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, veteran status or any other characteristic protected by law.

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