Manager – Revenue Integrity

This is a fully remote position, open to applicants in United States.

📋 Description

• Supervise professional personnel in managing, coordinating, and executing Charge Description Master (CDM) and charge capture initiatives and processes.

• Engage with senior leadership and interface with executive-level staff both internally and externally.

• Conduct education sessions on CDM and charge capture.

• Ensure compliance with government and non-government regulations and implement controls for audits and reviews.

• Facilitate communication and information flow regarding revenue management.

• Oversee timely and accurate updates to the patient accounting system to support data integrity and claims processing.

• Ensure quality reviews effectively identify and reduce system errors.

• Strategize revenue management using data and report analysis.

• Prepare, manage, and uphold the annual budget while maintaining budgetary controls.

• Act as a resource and consultant for customers and collaborate with internal departments.

• Lead a professional team in evaluating, planning, executing, and reporting on revenue management strategies.

• Assess and maintain workflow processes for optimal efficiency throughout the revenue cycle.

• Research and interpret regulatory guidance, changes in billing and coding, and managed care contracts.

• Provide solutions for incident management and problem resolution across the enterprise.

• Oversee special initiatives, including new client onboarding, system conversions, acquisitions, departmental changes, service lines, regulatory updates, and legal reviews.

• Manage strategic pricing initiatives and perform financial analyses.

• Supervise CDM and charge capture corrective actions and monitoring tools.

• Analyze statistics and key performance indicators to pinpoint areas for improvement and ensure compliance.

• Conduct interviews, hire, train, assign, guide, and evaluate employees; address complaints and resolve issues.

⛳️ Requirements

• Bachelor’s degree or higher; relevant experience may be considered in place of a degree.

• Previous supervisory experience is mandatory.

• At least five years of experience in a healthcare-related field is required.

• Comprehensive understanding of laws and regulations related to the healthcare industry is essential.

• Previous financial experience in healthcare or a related field within a hospital/integrated healthcare delivery system is required.

• Experience with CDM or charge capture is necessary.

• Excellent interpersonal communication and presentation abilities are required.

• Capable of articulating ideas clearly and succinctly to executives, management, facility groups, and individuals.

• Able to respond professionally to complex inquiries.

• Proficient in defining problems, collecting data, establishing facts, drawing conclusions, and making recommendations.

• Understanding of both external and internal factors affecting revenue management.

• Capable of analyzing state and federal regulatory information, managed care contracts, claims production systems, patient accounting systems, clinical/order entry systems, ancillary systems, and CDM.

• Ability to research published resources, reference materials, internet resources, seminars, and other relevant information sources.

• Proficient in MS Office applications, including Excel, Word, Access, and PowerPoint.

• Relevant clinical or professional certifications and licenses such as LVN, RN, RT, MT, RPH, CPC-H, and CCS are highly desirable.

• Must be able to sit for extended periods, use hands and fingers, reach, talk, and hear.

• Must frequently lift and/or move up to 25 pounds.

• Some travel may be required.

🏝️ Benefits

• Management level positions may qualify for sign-on and relocation bonuses.

• Comprehensive medical, dental, vision, disability, life, and business travel insurance.

• Paid time off (vacation & sick leave) – minimum of 12 days annually.

• 401k with up to a 6% employer match.

• Ten paid holidays per year.

• Health savings accounts available.

• Flexible spending accounts for healthcare and dependents.

• Employee Assistance Program provided.

• Employee discount program offered.

• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long-term care, elder & childcare support, AD&D, and auto & home insurance.

• For employees in Colorado, paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.