Manager Revenue Integrity

Location: Remote position associated with Livonia, Michigan, United States

Salary: $42.2592–$63.3888 per hour

Company

hirify.global is a large healthcare organization serving communities across 25 states through a network of colleagues, physicians, clinicians, hospitals, and medical groups.

What you will do

• Lead day-to-day revenue integrity operations for hospitals and/or Medical Group Provider Services.
• Manage the Charge Description Master, pre-bill edits, charge control processes, audits, and revenue optimization initiatives.
• Coordinate denial resolution with Patient Business Services and multidisciplinary teams, including root cause analysis and denial prevention.
• Monitor payer, Medicare, and Medicaid updates and implement changes affecting charging, coding, billing, compliance, and revenue performance.
• Prepare education, training, policies, procedures, management reports, and key performance indicators.
• Hire, schedule, coach, develop, and evaluate staff while managing projects and cross-functional collaboration.

Requirements

• Bachelor’s degree in Finance, Business Administration, or a related field, or an equivalent combination of education and experience.
• Five to seven years of progressively responsible revenue cycle experience, including revenue integrity.
• At least three years of management experience in a multi-facility integrated healthcare system, revenue cycle organization, or revenue integrity consulting environment.
• Experience with healthcare revenue integrity, appeals, denial management, medical necessity, coding audits, and medical chart review.
• Knowledge of CDM maintenance or oversight, payer contracts, billing laws, DRG, APC, OPPS, OCE/CCI edits, and DNFB.
• Ability to analyze data, interpret complex clinical and operational issues, manage staff, and collaborate with physicians, clinicians, administrators, payers, and governmental agencies.

Nice to have

• RHIA, RHIT, CCS, CPC/COC, or another coding credential.
• Healthcare compliance certification.

Culture & Benefits

• Remote work in a typical office environment with frequent communication across locations.
• Day-shift schedule with the possibility of varied or extended hours as workload and priorities change.
• Mission-driven healthcare environment focused on improving community health, care quality, affordability, justice, stewardship, and integrity.
• Commitment to diversity, inclusion, colleague development, continuing education, and person-centered care.