Revenue Integrity Manager

Job Description: • Lead and manage Revenue Integrity operations, ensuring accurate charge capture, coding, billing, and reimbursement processes. • Oversee the maintenance and governance of the Charge Description Master (CDM), including code updates, pricing changes, and regulatory compliance. • Ensure proper mapping of charge codes and billing workflows within the hospital information system. • Develop and implement charge audit, reconciliation, and monitoring processes to identify revenue leakage and improve revenue capture. • Conduct financial and operational reviews to assess charge capture accuracy and billing completeness. • Ensure compliance with payer requirements, healthcare regulations, and coding standards including CPT, HCPCS, and DRG methodologies. • Collaborate with clinical, finance, revenue cycle, billing, and insurance departments to improve revenue cycle performance. • Lead cross-functional initiatives focused on revenue enhancement, operational efficiency, and process improvement. • Oversee pricing structures and support the preparation of patient and payer cost estimates. Qualifications • Bachelor's degree in Healthcare Administration, Health Information Management, Finance, Accounting, Business Administration, or a related field. • Master's degree preferred. • Professional certification such as CPC, CCS, RHIA, RHIT, CHFP, or equivalent preferred. • Strong knowledge of healthcare revenue cycle operations, coding compliance, and reimbursement methodologies. Requirements • Minimum 5-7 years of progressive experience in Revenue Cycle, Revenue Integrity, Patient Financial Services, Healthcare Finance, or related healthcare operations. • Demonstrated experience managing Charge Description Master (CDM) processes and charge capture programs. • Strong knowledge of CPT, HCPCS, DRG, revenue codes, and payer reimbursement methodologies. • Experience with healthcare information systems, preferably Cerner or equivalent electronic health record and billing platforms. • Excellent analytical, auditing, and problem-solving skills. • Strong leadership and stakeholder management capabilities. • Ability to lead multidisciplinary teams and drive process improvement initiatives. • Excellent communication and presentation skills.