Director Revenue Integrity

Education
Bachelors Degree and 10 years experience required. Or Masters Degree and 8 years experience is preferred

Experience
8 years progressive leadership experience in healthcare revenue cycle revenue integrity charge capture charge reconciliation charge compliance auditing coding finance clinical operations or related healthcare operations. Experience must include Epic EMR and leadership of complex operational functions large-scale projects operational transformation initiatives process improvement efforts and technology implementations with demonstrated success driving organizational performance financial outcomes regulatory compliance and cross-functional collaboration. (with a Masters) required.

Or 10 years progressive leadership experience in healthcare revenue cycle revenue integrity charge capture charge reconciliation charge compliance auditing coding finance clinical operations or related healthcare operations. Experience must include Epic EMR and leadership of complex operational functions large-scale projects operational transformation initiatives process improvement efforts and technology implementations with demonstrated success driving organizational performance financial outcomes regulatory compliance and cross-functional collaboration. (with a Bachelors) required.

Licenses and Certifications
CRCR - Certified Revenue Cycle Representative Obtain and maintain through THR HFMA Enterprise membership required within 12 months of hire
CPC - Certified Professional Coder or RHIA - Registered Health Information Administrator preferred upon hire

Skills
Expert knowledge of healthcare revenue cycle operations charge capture charge audit charge compliance reimbursement methodologies and payer requirements. Advanced understanding of CMS regulations regulatory compliance healthcare finance denials prevention and revenue optimization strategies. Demonstrated ability to lead large complex enterprise-wide initiatives and organizational change efforts. Strong financial acumen with ability to quantify impact evaluate risk and develop business cases. Advanced leadership communication executive presentation negotiation and stakeholder management skills. Ability to influence decision-making across executive physician operational financial and clinical leadership groups. Strong analytical strategic planning organizational development and performance management capabilities.
MS Office including Word PowerPoint Excel and Outlook

Travel Requirements
Local 10% In-person meetings at assigned office location or at THR facility

Why Texas Health

At Texas Health Resources our mission is to improve the health of the people in the communities we serve.

As part of the Texas Health family and its 28000 employees were one of the largest employers in the Dallas Fort Worth area. Our career growth and professional development opportunities are top-notch and our benefits are equally outstanding. Come be a part of our exceptional team as we improve the health of the people in our communities every day. You belong here.

Learn more about our culture benefits and recent awards.

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Director Revenue Integrity

Position Highlights

The Director of Revenue Integrity provides strategic operational and organizational leadership for enterprise-wide charge capture governance charge reconciliation audit escalation strategy charge compliance clinical documentation improvement initiatives related to charging accuracy revenue leakage prevention denials prevention regulatory compliance and revenue integrity optimization.

The Director leads managers and teams responsible for charge capture operations charge audits revenue integrity analytics charge reconciliation charge compliance education and performance improvement activities. The role establishes enterprise standards develops long-term strategies oversees organizational performance and partners with executive leadership clinical departments finance compliance IT coding billing and revenue cycle leaders to ensure accurate compliant and efficient revenue recognition across the organization. The role is accountable for establishing a culture of operational excellence standardization accountability and continuous improvement while ensuring alignment with organizational financial compliance and strategic priorities.

• Work location: Texas Health Resources-Remote work is available for local candidates within the Dallas/Fort Worth area
• Work hours: Full Time Monday Friday 08:00 AM 5:00 PM

Key Responsibilities

Revenue Integrity Strategy & Governance
. Serve as Revenue Integrity subject matter expert and strategic advisor for the organization
. Lead stakeholder engagement change management communication and governance activities related to revenue integrity initiatives
. Establish and execute the organizations Revenue Integrity strategy governance framework and operating model
. Establish enterprise standards for charge capture workflows charge audit methodology charge reconciliation documentation requirements and education practices
. Ensure alignment of Revenue Integrity objectives with organizational financial operational regulatory and strategic priorities

Operational Leadership & Performance
. Monitor departmental performance through dashboards scorecards service level agreements and key performance indicators
. Ensure timely resolution of enterprise charge capture issues billing barriers reconciliation variances and audit findings
. Oversee performance management workforce planning succession planning and leadership development activities
. Lead prioritization of enterprise projects operational initiatives and resource deployment
. Foster a high-performing culture focused on accountability collaboration innovation and customer service

Compliance Audit and Risk Management
. Lead and oversee analysis of charge capture trends recurring errors compliance risks revenue leakage opportunities documentation gaps and operational issues impacting revenue integrity performance
Direct retrospective concurrent targeted complex high-risk and payer-sensitive audits to evaluate charge accuracy documentation support and compliance with charging rules payer requirements and regulatory standards
. Ensure audit findings are documented tracked reported and translated into remediation plans education workflow changes or escalation pathways as appropriate
. Oversee root cause analysis for moderately complex recurring systemic cross-functional or high-risk charge capture and documentation issues
. Ensure compliance with CMS regulations payer requirements organizational policies and industry standards
. Direct identification escalation remediation and monitoring of compliance risks audit findings revenue leakage opportunities and billing vulnerabilities

Revenue Optimization & System Improvement
. Drive organizational efforts to improve revenue capture reduce revenue leakage and strengthen financial performance
. Establish enterprise performance monitoring related to charge accuracy reconciliation outcomes denials prevention audit findings financial recovery and billing readiness
. Evaluate financial impact of operational issues and prioritize initiatives based on organizational risk and return
. Develop executive-level reporting and business cases to support investment decisions and operational improvements
. Lead initiatives that improve net revenue realization through enhanced charge capture accuracy documentation support and process standardization
. Lead enterprise process improvement initiatives to improve efficiency consistency compliance and scalability
. Partner with cross-functional teams to optimize system configuration automation opportunities work queues edits and reporting capabilities
Lead large-scale operational transformation initiatives impacting revenue integrity and revenue cycle performance
. Ensure consistent implementation of best practices across hospitals outpatient departments physician practices and ambulatory clinics and service lines
. Promote data-driven decision making and continuous process improvement throughout the organization

Required Experience:

Director