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Revenue Integrity Manager
Job Description
Provide leadership and supervision to the Revenue Integrity and/or CDM team. Ensure effective collaboration between providers, coders, and billers to support compliant documentation and optimal coding outcomes. Collaborate with clinical providers to enhance documentation quality and accuracy, supporting compliant billing, appropriate risk stratification, and accurate Uniform Data System (UDS) reporting. Conduct routine internal audits and chart reviews to monitor accuracy, identify trends, and implement corrective actions supporting compliance and data integrity. Maintain current knowledge of federal, state, and payer coding regulations and update internal protocols and workflows to ensure compliance and operational consistency. Monitor productivity, accuracy, and quality metrics; develop and implement performance improvement plans to meet departmental and organizational benchmarks. Collaborate with billing, clinical, quality, and compliance teams to enhance communication, improve documentation workflows, and ensure alignment between coding practices and organizational goals. Review high-volume accounts assigned to Revenue Integrity work queues for charge review and charge entry, including observation accounts, procedure carve-out reviews, extended recovery carve-out time, injection and infusion charges, and related activities. Analyze inpatient and outpatient records for appropriate charging, coding reviews (NCCI edits, MUE edits, medical necessity edits), and denials. Serve as a resource to hospital departments regarding charging questions, audits, billing issues, and educational opportunities. Maintain established productivity requirements and a 95% or greater accuracy rate. Revenue Integrity Specialist RN Auditor Hiring, onboarding, training, and developing team members Performance management, coaching, and employee evaluations Scheduling and workforce planning Employee relations and corrective action administration Work allocation and prioritization Budget planning and departmental resource management Policy enforcement and compliance oversight Ensuring a safe and secure work environment Three (3) years of management experience within Revenue Cycle, Acute Care, or Health Information Management required. Five (5) years of revenue analysis, charging, auditing, or coding experience in an acute care setting required. Master's Degree Candidates with a nursing degree must maintain an active, unrestricted nursing license and/or obtain a Certified Professional Coder (CPC) credential within six (6) months of hire. Candidates with education or degrees in other disciplines must obtain a CPC credential within six (6) months of employment. Bachelors or better in Business Administration or related field. Masters or better in Other. Certified Professional Co Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Benefits
- Dental Insurance