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Title:  Director Revenue Integrity

Division:  Children's Hospital of San Antonio
Schedule:  Monday - Friday 8:00 a.m. - 5:00 p.m.
Work Location:  San Antonio, TX
Salary Range:  Commensurate with experience
FLSA Status:  Exempt
Requisition ID:  1698
Job Purpose

The Director of Revenue Integrity is responsible for the revenue integrity and physician revenue education function.


 

Job Responsibilities
  • Conduct initial and continuous assessment of the revenue environment through a combination of chart reviews, interviews, and evaluation of Athena revenue cycle function to identify areas of improving and capturing revenue.
  • Develop and implement a revenue integrity and physician education program that is tailored to the needs identified in the assessment phase.
  • Function autonomously to obtain leadership buy-in and support working closely with executive and physician leadership.
  • Develop revenue integrity educational materials and educate physicians and other providers using various modes of delivery, including, but not limited to in-person education and interactive on-line education using the College’s Learning Management System. 
  • In consultation with The Office of Compliance, develop, implement and maintain billing and revenue cycle policies and procedures and manuals in support of revenue integrity and the revenue integrity education program.
  • Implement practices to continuously improve the function based on the analysis of data and other feedback.
  • Develop annual budgets and allocate resources in support of the function.
  • Report identified payer audits and other billing compliance risk areas to Compliance and work collaboratively with Compliance Leadership as requested to remediate identified billing compliance risk areas.  Work collaboratively with Revenue Teams to implement appropriate policies within the Athena revenue cycle function to ensure accurate billing of health care items/services consistent with payer policies.
  • Provide guidance to CPG and physicians on appropriate billing of healthcare items and services consistent with commercial payer policies, routing billing compliance requests/issues to Compliance.
  • Prepare quarterly reports of activities for physician leadership and the Executive Leadership Team.
Minimum Qualifications
  • Required: Bachelor’s degree in a related field.
  • Required: Seven years of relevant experience.
Preferred Qualifications

Fifteen to twenty years of direct experience.

 

 

 

 

Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.

 1698

CA; CH