Revenue Integrity Manager

• Location: Remote
• Department: Revenue Cycle Administration
• Schedule: Days | Full-Time

#InternalOps

• CDM Optimization & Charge Master Governance: Demonstrate working knowledge and exposure to Charge Description Master (CDM) structures, governance, and best practices. Evaluate and validate CPT/HCPCS coding, revenue code mappings, pricing, and system configuration for new clinical initiatives, changes follow established CDM standards, regulatory requirements, and reimbursement best practices.
• Advanced Revenue Analytics & Denials Mitigation: Perform deep-dive statistical analysis on charge-level data, claim denials, and remittance advice to uncover root causes of underpayment, quantify revenue opportunities, and design operational mitigation strategies.
• Reporting Infrastructure & KPI Tracking: Develop, deploy, and maintain reports and monitoring tools to track charge-capture variance, operational reconciliation rates, and the financial ROI of revenue integrity initiatives.
• Cross-Functional Project Leadership & Corrective Action: Lead multidisciplinary performance improvement initiatives across clinical, revenue cycle, and IT leadership to resolve compliance risks, establish sustainable operational controls, and deliver targeted charge-capture education.

Licensure / Certification / Registration:

• Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA) preferred. Licensure required relevant to state in which work is performed.

Education:

• High School diploma equivalency with 3 years of cumulative experience OR Associate's degree/Bachelor's degree with 2 years of cumulative experience OR 7 years of applicable cumulative job specific experience required.
• 3 years of leadership or management experience preferred.

Additional Information:

• Perform targeted Revenue Integrity audits and root-cause analysis to pinpoint missed charges, documentation gaps, and revenue opportunities while translating federal, state, and payer regulatory updates into compliant charging strategies.
• Validate and optimize revenue-cycle workflows across Epic, Oracle Health/Cerner, and related applications to ensure seamless system functionality, accurate charge capture, and aligned billing operations.