Manager Revenue Integrity

Job Overview

Manager Revenue Integrity at Baylor Scott & White Health

The Manager of Revenue Integrity performs duties of moderate to high complexity, judgement, and scope under the direction of the Baylor Scott & White Health's Director of Revenue Integrity. This position is responsible for the oversight of a team that ensures that the Charge Description Master (CDM) and hospital and professional charge capture methodologies and workflows are compliant with Federal, State, and third‑party payor guidelines and requirements.

The Manager is responsible for the planning and implementation of charge capture and charge reconciliation audit programs, developing work teams, assigning tasks, and coordinating departmental projects, workflow, training and development of staff, and assisting in managing the departmental budget.

• Will be onsite for department meetings and  go live  events.
• Must live in the Baylor Scott & White service area (DFW, Central Texas, College Station, Greater Austin Region).

Collaborates with the BSWH Director of Revenue Integrity to develop department strategy, structure, productivity standards/metrics, applicable policies and procedures, etc. Responsible for hiring, training, developing, and evaluating assigned direct reports and provides ongoing oversight and support to direct reports and assigned service lines.

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.

Partners with other Revenue Cycle, clinical, and Information Services departments to identify, research, and resolve charge capture issues. Maintains knowledge of all charge capture methodologies, workflows, and processes for assigned service lines.

Shares ownership in the development of the Revenue Integrity Audit Program annually in collaboration with the Director of Revenue Integrity. Evaluates charge capture workflows across all service lines and identifies areas of risk for inclusion in the audit program. Establishes scope, schedules, and timeline, assigns responsibilities, drafts/edits audit reports, and presents findings to applicable department, facility, and system leadership.

Responsible for ensuring the accuracy of all key data elements of the Charge Description Master (CDM) and remains updated with all government and commercial payor coding and regulation changes through a system-wide CDM program.

Assists with establishing and implementing CDM-related policies and procedures including an annual CDM Audit program. Serves as an internal resource to inform and consult with departments when regulatory changes occur to ensure ongoing charge capture and CDM compliance.

Develops strategy for performing CDM and charge capture education and assists direct reports with providing education to key stakeholders.

Supports new department, facility, and service implementations for the Revenue Cycle to ensure charge capture is performed accurately, consistently, and compliantly by serving as a project manager, 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 workflows to support the BSWH Charge Reconciliation policy and procedure across all revenue generating departments. Responsible for ensuring frequent and consistent Charge Reconciliation training and education is provided to department leaders. Establishes and executes a Charge Reconciliation audit program in line with the larger Revenue Integrity Audit program.

Performs other position appropriate duties as required in a competent, professional, and courteous manner.

• Exceptional verbal and written communication skills, manifesting in the ability to create and edit executive-ready communications that are informative, concise, 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…