Hospital Revenue Integrity Manager

Overview

• Lead and manage revenue integrity operations, ensuring compliance and optimizing charge capture processes for inpatient and outpatient services.
• Collaborate with clinical, coding, and financial teams to enhance billing accuracy and prevent revenue leakage.
• Supervise and mentor a team of 12 professionals, fostering professional growth and development.
• Maintain and update the chargemaster and physician fee schedules for multiple facilities.
• Support organizational growth initiatives, including new service expansions and internal talent development.
• Ensure compliance with federal, state, and payer regulations, including Medicare and Medicaid guidelines.
• Analyze workflows and data to recommend solutions and improve operational efficiency.
• Contribute to strategic planning and implementation of revenue integrity projects.

Key Responsibilities & Duties

• Manage daily operations of the chargemaster and physician fee schedules, ensuring accuracy and compliance.
• Collaborate with the Director of Charge Capture Integrity to address and prevent charge capture errors.
• Supervise and train revenue integrity staff, promoting skill development and team cohesion.
• Coordinate with clinical departments to optimize charge creation and entry processes.
• Ensure compliance with coding standards, including CPT, HCPCS, and ICD coding.
• Analyze financial workflows and recommend improvements to enhance revenue capture.
• Lead cross-functional initiatives to support organizational financial objectives.
• Prepare reports and presentations for leadership on revenue integrity performance metrics.

Job Requirements

• Bachelor’s degree in a related field is required.
• Minimum of 5 years of experience in revenue integrity or chargemaster maintenance.
• At least 3 years of management experience in a hospital or physician group setting.
• Certified Coding Specialist (CCS), CCS-P, or CPC certification preferred or willingness to obtain within two years.
• Proficiency in CPT, HCPCS, ICD coding, and revenue code assignment.
• Strong analytical skills and ability to manage complex projects effectively.
• Excellent communication and leadership skills, with a focus on team empowerment.
• Experience with CERNER or Soarian systems is highly desirable.