Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical Center the hospital is the home of the Texas Heart® Institute a cardiovascular research and education institution founded in 1962 by Denton A. Cooley MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center receiving the award five consecutive times. Baylor St. Luke’s also has three community emergency centers offering adult and pediatric care for the Greater Houston area.

The Director of Revenue Cycle reports directly to the Division Vice President of Physician Enterprise and works collaboratively within Division stakeholders to develop revenue cycle strategies and develop integration and implementation plans for the various markets within the CHI Texas Division. Additionally, this role will be responsible for patient registration, verification, and authorization of benefits and time of service collections, revenue integrity; including, charge capture, contract management, underpayments, charge description master, and pricing, and Health Information Management.

1. Develop revenue cycle strategies and develop integration and implementation plans for the various markets within the CHI Texas Division.2. Establishes Revenue Cycle performance standards and processes, including KPIs and A/R days Collection/wRVU, preventable denials (top 5 monthly), write offs for bad debt, patient/insurance refunds, matched payment/charges, review of top 5 payers with top 20 CPT codes and comparison of allowable to payment.3. Assist with patient access and workflow for optimization4. Responsible for the Revenue Cycle, incorporates legislation, Federal regulations, and payment from both governmental and private payers5. Resolves complex revenue cycle issues and escalations.6. Manages 3rd Party vendors to improve patient financial Services including billing, collections, denials management, cash posting, accounts receivable management, and credit balance reconciliation.7. Reviews operations data, budgets, audits, forecasts, accounts receivable, market data, staffing reports, third party billing, and collection processes to improve operational performance and to align with industry best practices.8. Reviews net revenue projections including managed care, under or overpayments; assesses pricing, and charge description master; aligns revenue strategies with organizational goals to improve performance and to align withindustry best practices.

9. Utilizes accounting principles in relation to debit and credit transactions, charge transfers, contractual allowances,
adjustments, and accounts receivable; implements and develops revenue best practice methodology.
10. Provides direction on compliance with HIPAA, state and federal regulations regarding patient access, billing,
collections, and refunds.

Required Education & Experience:

* Bachelor’s degree in related discipline

* 7 years of experience and 5 years of leadership experience

Required Knowledged, Skills, Abilities and Training:

* Knowledge of various coding systems used in the Physician Enterprises (e.g., CPT/HCPCS Coding, ICD10). Requires high analytical skill, fundamental understanding of health care financial management. Must possess organizational andcommunication skills. Computer knowledge (Desktop, Database, Charge Master/Epic, eCW Software applications and Internet Access)

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