Associate Vice President Revenue Management Controls and Compliance Job at Geisinger, Danville, PA

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  • Geisinger
  • Danville, PA

Job Description

Job Title: Associate Vice President Revenue Management Controls and Compliance
Location: Danville, Pennsylvania
Job Category: Revenue Management
Schedule: Days
Work Type: Full time
Department: Office of the Chief Revenue Officer
Date Posted: 04/16/2024
Job ID: R-60513

Job Summary

​Provides direction and oversight for billing and coding compliance related activities of Revenue Cycle. Specifically manages the audits of practitioner coding and documentation and performs coding audits in support of Geisinger’s Corporate Compliance Plan. Manages the responses to all audits performed by governmental and commercial third-party payers. Manages regulatory audits. Additionally, provides analysis and recommendations on billing and compliance issues. Provides oversight for the team responsible for the objective appraisal and evaluation of Revenue Management’s system of internal controls with special focus on those that have been designated as key controls. The team maintains the narrative of the revenue cycle and provides and performs audits and internal control assessments on an ad hoc basis. Provides oversight for the team responsible reviewing, designing, and implementing processes for security testing and performing regular audits on the role-based user security assignments.

Job Duties

  • Manages   all   operations   within   the   Compliance,   Internal   Controls   and   Security   Department   in   conjunction   with   direction   from   leadership.
  • Provides   oversight,   direction,   and   support   of   staff   and   all   compliance   related   activities,   including   Internal   Controls   and   Security   Testing.
  • Responsible   for   development,   maintenance   and   implementation   of   Revenue   Management’s   Compliance   Program.
  • Interfaces   with   all   relevant   departments   to   coordinate   and   monitor   consistency   with   Compliance   Program and   with   applicable   regulatory   requirements   and   reports   these   results   to   the   appropriate   leader   and   administrative   departments.
  • Expected   to   be   the   subject   matter expert   regarding   issues in   the   field   of   coding and   billing   compliance.
  • Leads   efforts   within the   organization   to   promote   compliance   through   education,   training,   audits,   and   other means   as   appropriate.
  • Coordinates   external audits,   including   appropriate   response   and   the   preparation   of   operational   improvement   plans.
  • Disseminates   information   to   key   stakeholders   on   a   timely basis.   Reports   compliance   activity   to   various internal   compliance   committees   as   needed.
  • Responsible   as   Medicare compliance   subject   matter   expert   for   understanding   all   regulatory   requirements   applicable   to   the   Medicare   line   of   business,   and   for   tracking changes   to   such   requirements.
  • With   respect   to   governmental   payers, coordinates   the   development   of   and   oversees the   implementation   and   maintenance   of   an   investigation   and   remediation   process to   ensure   prompt response   to   an   investigation   of   any   action inconsistent   with   applicable  regulatory   requirements.
  • Reports   the   results   of   internal   control   testing  to   leadership   and   makes   recommendations   on   corrective   action   plans.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Education

Bachelor's Degree- (Required), Master's Degree- (Preferred)

Experience

Minimum of 5 years-Managerial/Supervisory (Required), Minimum of 7 years-Related work experience (Required)

Our Purpose & Values

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

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Job Tags

Full time, Part time, Work experience placement,

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