Sr Director, Rev Integrity

Guthrie Health-posted 3 months ago
Full-time • Senior
Sayre, PA
5,001-10,000 employees
Religious, Grantmaking, Civic, Professional, and Similar Organizations
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The Senior Director, Revenue Integrity is responsible for developing and executing the strategic vision for The Guthrie Clinic and revenue integrity program. The Senior Director is responsible for the oversight of the standard workflows/processes that impact the Revenue Integrity functions: chargemaster, Federal, State & managed care contract rule development and charge capture and reconciliation interacting with providers and business owners. Also responsible for key components of monthly AR valuation and corporate revenue cycle forecast preparation, reporting, and updating. Works closely with RAC and Finance leadership to prepare and analyze forecast and actual expense data to support leadership. This role serves as the Revenue Cycle Revenue Integrity leader for The Guthrie Clinic to internal and external organizations, including government agencies, payor organizations, vendors, external auditors, and business partners.

  • Work with VP, Corporate Revenue Cycle to develop and execute the enterprise-wide revenue integrity strategy aligned with organizational goals.
  • Lead cross-functional initiatives to improve charge capture accuracy, reduce revenue leakage, and enhance operational efficiency.
  • Oversee configuration and optimization of Epic modules related to charge capture, proration, and billing workflows.
  • Oversee the loading, validation, and maintenance of payer reimbursement rates in the hospital electronic health record System (EPIC HB) for Federal, State, and Commercial plans following the build approval process.
  • Collaborate with IT and clinical informatics to ensure Epic supports compliant and efficient revenue processes.
  • Ensure accurate and timely charge capture across all service lines. Lead initiatives to automate and streamline proration logic and workflows within Epic.
  • Direct the maintenance and integrity of the chargemaster, ensuring alignment with coding, billing, and reimbursement guidelines.
  • Partner with finance and compliance to ensure pricing transparency and regulatory adherence.
  • Serve as a liaison between revenue cycle and clinical departments to educate and support providers on documentation and charge capture best practices.
  • Facilitate regular meetings with clinical business owners to review performance metrics and identify improvement opportunities.
  • Bachelor's degree from a recognized college or university or 7-10 years-experience senior level revenue cycle leadership in lieu of degree.
  • At least seven (7) years of management experience patient access-related functions, clinical operational, and/or project management within a progressive healthcare environment.
  • Deep expertise in Epic EHR, particularly in charge capture, proration, and billing modules.
  • Excellent written, verbal communication and interpersonal skills.
  • Time management and organizational skills.
  • Self-directed with the ability to work with various stakeholders and teams.
  • Ability to make quality, independent decisions as well as the ability to collaborate effectively to make decisions with other leaders.
  • Superior analytical and problem-solving skills.
  • Ability to work effectively and efficiently under tight deadlines, high volumes, and multiple interruptions.
  • Proficiency with Microsoft Office (Word, PowerPoint, & Excel).
  • Leader or member of a revenue cycle transformation effort where key functions were reviewed for standardization and centralization.
  • Revenue cycle leadership in a multi-hospital and employed physician environment.
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