Description

*About Us* Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: * We serve faithfully by doing what's right with a joyful heart. * We never settle by constantly striving for better. * We are in it together by supporting one another and those we serve. * We make an impact by taking initiative and delivering exceptional experience. *Benefits* Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: * Eligibility on day 1 for all benefits * Dollar-for-dollar 401(k) match, up to 5% * Debt-free tuition assistance, offering access to many no-cost and low-cost degrees, certificates and more * Immediate access to time off benefits At Baylor Scott & White Health, your well-being is our top priority. Note: Benefits may vary based on position type and/or level *Job Summary* Director Revenue Integrity will serve as a strategic leader and resource for the design, implementation, operation, maintenance, monitoring, and overall quality of the BSWH Revenue Integrity functions. Additionally, they direct a coordinated system-wide Revenue Integrity program to ensure BSWH compliance with Federal, State, commercial payor, and other applicable legal and regulatory requirements for the BSWH Revenue Cycle. This includes developing the overall department strategy, structure, productivity standards, metrics, policies and procedures. The Director Revenue Integrity is responsible for hiring, training, developing, and evaluating assigned direct reports as well as providing leadership support for the entire Revenue Integrity team. *Essential Functions of the Role:* * Ensures the accuracy of all key data elements of the Charge Description Master (CDM) (CPT/HCPCS codes, service descriptions, revenue codes, hard-coded modifiers, Relative Value Units, etc.) remain updated with all government and commercial payor coding and regulation changes through a system-wide CDM program for all wholly owned and operated hospitals, clinics, and employed medical groups. * Provides oversight of the development of charge capture methodologies and processes in coordination with the BSWH Revenue Cycle, Coding, Corporate Compliance, and Information Services (IS) teams. * Establishes and maintains effective lines of communication with both internal and external stakeholders. Sets strategy and provides guidance and advice throughout the system on all matters relating to Revenue Integrity. * Serves as the definitive resource and point of contact to provide guidance and advice regarding the Charge Description Master (CDM) and charge capture related topics throughout the System to all BSWH key stakeholders (including, but not limited to, facility and department leaders, corporate leaders, Information Services, clinical teams, physicians, Informatics, and Revenue Cycle leaders). Partners with other Revenue Cycle, clinical, and Information Services departments to identify, research, and resolve charge capture issues. Maintains high-level knowledge of all charge capture methodologies, workflows, and processes. * Develops a charging-focused educational strategy to ensure individuals involved in the Revenue Integrity process receive all necessary education, training, and resource materials to enable them to fulfill their responsibilities in an accurate and timely manner. This includes both the Revenue Integrity team as well as hospital/clinic stakeholders. * Oversees a system-wide strategy to identify Revenue Integrity risk areas. Coordinates as needed with BSWH Internal Audit to develop, oversee, and coordinate a system-wide auditing and monitoring program of charging-related risk areas. Develops annual work plans, conducts audits, offers solutions and provides guidance to other BSWH teams in conducting audits, and oversees follow up activities. * Oversees the development and execution of the BSWH Charge Reconciliation policy and procedure across all revenue generating departments. Responsible for establishing and providing support for a Charge Reconciliation audit program in line with the larger Revenue Integrity Audit program. * Plans, directs, and coordinates ongoing monitoring and implementation of charge-capture related technology solutions across BSWH. * Supports new hospital, department, service, and/or software implementations for the Revenue Cycle to ensure charge capture is performed accurately, consistently, and compliantly. Provides support to the Revenue Integrity team as they are reviewing regulations, designing, and reviewing charge capture workflow build, and ensuring post-go-live charge capture audits are performed and identified issues are mitigated. * Develops and maintains system-wide Revenue Integrity policies and procedures. Periodically reviews policies and procedures and updates or adds new policies and procedures as needed. * Performs other position appropriate duties as required in a competent, professional, and courteous manner. *Key Success Factors:* * Exceptional verbal and written communication skills, manifesting in the ability to create and edit executive-ready communications that are concise, informative, and free of spelling and grammatical errors and which inspire engagement and participation from individuals at all levels of the organization. * The ability to effectively manage multiple high-priority and high-visibility projects simultaneously, including informal leadership of projects not directly within the scope of responsibility. * Ability to oversee and execute complex tasks through an organized and detail-driven approach, to problem-solve, to predict and mitigate up- and down-stream implications of actions, as well as long-term viability of plans. * Ability to work independently and as a part of a team in a fast-paced, unpredictable, and deadline-driven environment while also managing a team of high-achieving, remote professionals. Self-motivated with ability to proactively identify and resolve issues and advance personal knowledge. * Ability to provide leadership and guidance to direct reports, supporting growth and personal development while ensuring department objectives are accomplished. * Advanced knowledge of Excel and data analytics to include formulas, functions, and pivot tables in order to analyze large data sets, draw conclusions, and make and implement decisions. * Adept in researching complex questions, providing recommendations, making decisions, and devising strategies to result in appropriate outcomes. * Ability to understand, interpret, determine the impact of, and respond to complex instructions from state and federal governing entities, and to ensure the response to these instructions results in appropriate outcomes. * Exceptional organizational skills. * Maintains knowledge of Revenue Codes and CPT/HCPCS coding methodologies and has a comprehensive knowledge of healthcare billing, finance, and reimbursement. * Epic Hospital Billing, Professional Billing, and Chargemaster experience preferred. *Belonging Statement* We believe that all people should feel welcomed, valued and supported, and that our workforce should be reflective of the communities we serve. *QUALIFICATIONS* * EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification * EXPERIENCE - 5 Years of Experience