Director, Clinical Revenue Compliance; Auditing

Director, Clinical Revenue Compliance (Auditing) – College of Dentistry, New York University – New York, NY

Design, develop and implement the College’s monitoring program for accounting and financial control systems related to clinical revenue data. Develop, plan and evaluate the monitoring program for the College’s accounting and statistical records and activities within the College of Dentistry to ensure compliance with NYU and school policies, procedures and standards. Perform compliance and monitoring assessments to identify exceptions to establish claims adjudication requirements for pre‑EOB and after‑posting of payments.

Prepare assessment reports for management concerning scope of assessment, root causes and potential control gaps in the process, and participate in the development of remediation strategies.

• Plan, develop and implement compliance monitoring programs for clinical revenue data.
• Conduct compliance and monitoring assessments to identify exceptions and establish claims adjudication requirements.
• Prepare assessment reports for management, detailing scope, root causes and control gaps.
• Participate in the development of remediation strategies to address identified gaps.

• Required
  
  Education:
  
  Bachelor’s Degree in Clinical Revenue Compliance accounting, finance, business or healthcare administration.
• Preferred Education: Master’s Degree in business or healthcare administration.
• Required Experience: 7+ years of relevant professional-level experience in a claims processing environment.
• Preferred Experience: Experience working in an Academic Dental Center, major dental group practice or Claims Adjudication area of an Insurance Carrier.
• Required Skills, Knowledge and Abilities: Effective planning, analytical, communication and project management skills; proven ability to develop and implement compliance monitoring; expertise in analyzing financial data related to clinical documentation; proficiency with Microsoft Office and statistical audit software; comprehensive knowledge of regulations governing Article 28 and dental quality assurance programs.
• Preferred Skills, Knowledge and Abilities: Knowledge of Medicaid and HIPAA including administrative best practices for a dental/health‑care environment.

In compliance with NYC’s Pay Transparency Act, the annual base salary range for this position is USD $ to USD $.

NYU is an Equal Opportunity Employer and is committed to a policy of equal treatment and opportunity in every aspect of its recruitment and hiring process without regard to age, alienage, caregiver status, childbirth, citizenship status, color, creed, disability, domestic violence victim status, ethnicity, familial status, gender and/or gender identity or expression, marital status, military status, national origin, parental status, partnership status, predisposing genetic characteristics, pregnancy, race, religion, reproductive health decision making, sex, sexual orientation, unemployment status, veteran status, or any other legally protected basis.

All interested persons are encouraged to apply at all levels.

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