"Director, Clinical Revenue Compliance (Auditing)"

Director, Clinical Revenue Compliance (Auditing)

Job ID: 2025-15008

Location: US-NY-New York

Type: College of Dentistry (DN1032)

# of Openings: 1

Category: Finance/Real Estate/Procurement/Grant Management

Overview

Design, develop and implement the College's monitoring program for accounting and financial control systems related to clinical revenue data. Develop, plan and evaluate 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.

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 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 that will assess the effectiveness of NYU Dentistry controls and processes to support best in class business practices. Expert ability to analyze, extract and interpret patient financial data as it relates to clinical documentation and diagnosis/procedural coding of services provided. Expertise in Microsoft Office suite and statistical audit software. Comprehensive knowledge of regulations governing Article 28 and dental quality assurance program.

Preferred Skills, Knowledge and Abilities:
Knowledge of Medicaid and HIPAA including administrative best practices for dental and/or health-care environment.