Director Revenue Integrity - Hybrid

SGHS•Brunswick, GA

1d•Hybrid

About The Position

This role serves as the strategic and operational bridge between clinical operations, finance, IT, coding, billing, contracting, and compliance. The Director leads proactive “fix and find” initiatives to prevent revenue leakage, reduce denials, improve audit readiness, and establish durable governance over pricing, charge capture, billing, payments, and payer performance.

Requirements

Bachelor’s degree in Finance, Healthcare Administration, Business or related field
8-10+ years of progressive experience in Revenue Integrity, Revenue Cycle, or healthcare finance required.
Proven experience leading cross-functional initiatives and teams required.
Proven ability to coach and train service line leadership in revenue cycle practices.

Nice To Haves

Experience with Chargemasters, Cerner, Epic, Meditech, or similar EHRs preferred.

Responsibilities

Design and lead the Revenue Integrity strategy, governance model, and multi-year roadmap
Establish policies, controls, and accountability across all Revenue Integrity pillars
Own enterprise CDM governance, maintenance, and pricing methodology
Ensure alignment between CDM build, clinical workflows, and regulatory requirements
Oversee charge capture accuracy across hospital, professional, ASC, pharmacy, and supplies
Lead charge reconciliation processes (schedule-encounter-charge-claim)
Reduce preventable claim errors, rejections, and denials
Partner with Coding, HIM, and Billing to enforce payer rules, modifiers and documentation standards
Ensure accurate posting of payments, adjustments, and patient responsibility
Develop KPIs, dashboards, and executive reporting for leadership