Revenue Cycle Senior Director, Coding & Revenue Integrity

• Job Type: Officer of Administration
• Hours Per Week: 35
• Standard Work Schedule: Core business hours Monday-Friday, schedules vary
• Building: Fort Lee, NJ
• Salary Range: $150,000 - $275,000

Position Summary

Reporting to the Chief Revenue Cycle Officer, the Senior Director of Coding & Revenue Integrity serves as a strategic leader overseeing all medical coding, charge capture, and revenue integrity functions within the department, ensuring accurate, compliant, and timely medical coding aligned with institutional policies and payer guidelines. This leadership role provides strategic direction, operational leadership, and compliance oversight to ensure accurate, efficient, and compliant coding operations that align with institutional objectives, regulatory requirements, and payer guidelines.

The Senior Director provides strategic oversight to ensure the delivery of efficient, accurate, and compliant coding services across a broad range of departments supported by the Centralized Clinical Revenue Office.

The role encompasses the development of innovative solutions, implementation of strategic initiatives that drive revenue cycle optimization for ColumbiaDoctors, and efficient management of coding operations and revenue integrity, including automation, analytics, workflow enhancements

As a senior member of the CRO Revenue Cycle Management team, the incumbent will work to develop efficient processes and business solutions and promote best practice revenue cycle management within ColumbiaDoctors.

Responsibilities

Operations

• Lead and direct a large, centralized business office unit that manages coding and revenue integrity, ensuring operational efficiency and compliance with organizational standards, including contracted vendors.
• The Director leads a large coding team, including coders and managers, and collaborates closely with clinical, Billing Compliance, and other CUIMC offices to optimize coding performance and revenue integrity.
• Implement standardized coding processes, policies, and quality controls to ensure compliant and optimal coding.
• Leads the oversight and optimization of coding and revenue integrity operations, driving performance improvements and ensuring alignment with organizational goals, compliance standards, and financial objectives.
• Collaborates closely with CRO directors and department liaisons on coding and revenue integrity matters, serving as the leadership subject matter expert to guide best practices and resolve complex issues
• Evaluates third-party coding options for cost effectiveness without losing coding accuracy. For third-party vendors engaged in coding, maintain relationship and oversight of results to ensure compliant, optimal coding.
• Evaluate productivity and quality across teams, using data-driven methods to set performance benchmarks, optimize workflows, and implement quality control measures. Establish guidelines for prioritizing tasks and set performance standards to meet regulatory and compliance requirements.
• Oversees productivity and quality of team and staff performance, including direct supervision of management team members.
• Determines guidelines for prioritizing work activities.  Evaluate workflow effectiveness and performance.  Assess QI metrics, implement quality, and audit control measures to achieve compliance.  Evaluate interventions to achieve optimum efficiency.  Makes policy and/or process recommendations as needed.
•  Leads and/or participates in various revenue cycle initiatives to maximize reimbursement and collections.  Represents Columbia at task forces and committees.  Leverages combined network resources to support Revenue Cycle’s programs and priorities in achieving organization-wide results. 
• Applies expertise and strategic thinking to revenue cycle platforms and workflows to maximize the organization’s coding performance results, and effectively contribute to own department, team, and/or broader organization results. 
• Assist in developing a training curriculum for coding and documentation with relevant stakeholders.
• Serves as a Revenue Cycle lead and subject matter expert.  Works closely with Epic enterprise, Compliance Office, Departments, vendors, and other stakeholders for optimal integration, achievement of service level agreements, and alignment with target key performance indicators.
• Conducts periodic evaluation of workflows, identifies issues, and develops strategies for corrective measures and strategic adjustments, as necessary.
• Stays at the forefront of industry changes, maintaining expertise in regulations and trends impacting revenue cycle management. Conduct environmental scans to identify potential gaps in current processes and develop strategic proposals for senior leadership. Apply expertise and strategic thinking to optimize revenue cycle platforms and workflows, aligning to operational objectives and minimizing financial risk. Use advanced analytics and reporting tools to develop key performance indicators and optimization and troubleshooting strategies.
• Develops and maintains excellent working relationships with Columbia University Departments, payers, and vendors.  Serves as liaison between CRO, Compliance Office, and Clinical Departments in the coordination of activities.

Strategic

• Ensures strategic alignment of unit goals to the overall CRO organization, mission, and vision.
• Collaborates with senior leadership to develop communication strategies that effectively convey changes, initiatives, and results across various stakeholder groups. Establish feedback channels and ensure continuous alignment with strategic priorities.
• Determines key performance indicators and implements performance improvement initiatives, as needed. Continuously seeks and implements operational improvements. Utilizes system dashboards and reports to monitor key performance indicators of operational workflows to ensure a holistic view of the Revenue Cycle. Develops revenue optimization and improvement strategies and utilizes a data-driven methodology to monitor progress.
• Works with senior leadership to develop project scope and deliverables. Manages project in multi-level capacity, including but not limited to creating long- and short-term plans, setting targets for milestones and adhering to deadlines, delegating tasks, ensuring continuous alignment with organizational goals, and communicating with senior leadership on progress and deliverables.
• Represents ColumbiaDoctors as coding representative between NYP, departments, and CRO to ensure efficient workflows around management of coding, charge capture, and documentation review processes.

People

• Partners with the Human Resources team (Central HR, FPO HR, and Service Corp) to develop HR strategy for the unit and engages the management team to execute the strategy. Clarifies roles and responsibilities of team members; ensures that necessary steering, review, and support functions are in place. Ensures that the purpose and importance of the team are clarified (e.g., team has a clear charter or mission statement); guides the team in setting specific and measurable short- and long-term goals.
• Establishes a culture of coaching and mentoring to facilitate continuous professional development.  Works with the management team to identify and mitigate any roadblocks to performance, evaluate the effectiveness of development.  Works with Central HR or other resources to set objectives and/or develop remediation/action plans. 
• Oversees execution of HR strategy and transactions: Performance Management, Talent Management, Recruitment & Retention, Succession Planning, Professional Development, and Employee Engagement.  Works with the management team to ensure timely submission of HR deliverables.
• Under the direction of central HR, ensures compliance with Columbia's and departmental policies and procedures with Human Resources.
• Identify and facilitate professional development opportunities for team members that expand their expertise and network, including but not limited to training, workshops, and special revenue cycle projects.

Compliance

• Ensure full compliance with applicable HIPAA, Billing Compliance, and other pertinent regulations, setting a standard for adherence within the Clinical Revenue Office, and foster a culture of compliance across all revenue cycle operations.
• Works closely with Billing Compliance to ensure that all coding initiatives, ducation and coding projects are following the Centers for Medicare and Medicaid as well as the New York State Office of Medicaid Inspector General regulations.
• Inform the Clinical Compliance working group of ongoing coding initiatives.
• Leads committees, task force, and work groups focused on compliance and operational integrity, driving cross-departmental collaboration to address complex regulatory challenge and negotiating cycle practices meet the highest standards of ethical and legal requirements.
• Implement an internal audit program to proactively identify compliance risks and remediate issues.
• All other duties and projects assigned.

Please note: While this position is primarily remote, candidates must be in a Columbia University-approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the responsibility of the employee and will not be reimbursed by the company.

Minimum Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• Minimum of 7 years of progressively responsible experience in medical coding and revenue cycle management.
• Prior team management experience.
• Active Certified Professional Coder (CPC) credential or equivalent certification.
• An equivalent combination of education and experience may be considered.
• Demonstrated skills in revenue cycle management, problem assessment, project management, analytical skills, and resolution and collaborative problem-solving in complex, interdisciplinary settings.
• Ability to manage high volume of data sets; extract, evaluate, clean, and summarize; conduct qualitative and quantitative data analysis and validation as applicable to revenue cycle areas of responsibility.
• Proficiency in medical billing terminology, CPT/ICD-10 coding systems, and payer guidelines.
• Ability to communicate effectively in both oral and written form. Must be able to create and deliver high-level communication presentations for senior leadership and other organizational stakeholders.
• Advanced level proficiency of Microsoft Office (Word & Excel) or similar software is required, and an ability and willingness to learn new systems and programs.
• Strong leadership, organizational, and customer service skills, demonstrating tact and sensitivity in stressful situations.
• Must successfully pass systems training requirements.

Preferred Qualifications

• Master’s Degree preferred
• Epic experience is highly preferred.

Competencies

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.