Revenue Integrity Manager, CDM Operations

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

📋 Description

• Oversee the strategic management, upkeep, and enhancement of the Charge Description Master (CDM).

• Collaborate with operational, finance, clinical, compliance, and IT departments to refine revenue integrity processes.

• Ensure compliance with CPT, HCPCS, ICD-10, CMS, and payer regulations.

• Perform CDM audits and pinpoint opportunities for improving charge capture accuracy and reimbursement.

• Administer annual and ongoing updates to code sets, pricing assessments, and regulatory modifications.

• Evaluate reimbursement trends and propose enhancements for operations and pricing strategies.

• Assist with system implementations, upgrades, and integrations that affect CDM workflows, including Epic.

• Create best practices and offer guidance to departmental leaders regarding CDM governance and charge capture procedures.

• Help resolve billing discrepancies, denial trends, and compliance issues.

• Promote process improvement initiatives aimed at boosting operational efficiency and financial outcomes.

⛳️ Requirements

• Bachelor's degree in Healthcare Administration, Health Information Management, Finance, or a related discipline.

• Over 5 years of experience in Revenue Integrity, CDM management, hospital billing, or healthcare reimbursement.

• In-depth knowledge of CPT, HCPCS, ICD-10, and payer reimbursement methodologies.

• Experience with hospital billing systems and EMR platforms (Epic preferred).

• Excellent analytical, organizational, and problem-solving abilities.

• Capability to handle multiple priorities in a dynamic consulting atmosphere.

🏝️ Benefits

• Flexible, remote work environment.

• Collaborative and highly skilled consulting team.

• Opportunity to engage with nationally recognized healthcare systems.

• Involvement in meaningful, high-impact healthcare projects.

• A fast-paced environment where your expertise is recognized and appreciated.