Manager, Revenue Integrity

Ensemble Health Partners • Work at Home - South Carolina - Other, SC

1d • $84,000 - $110,000

About The Position

The Manager of Revenue Integrity oversees revenue integrity and charge capture activities and is accountable for departmental performance and effectiveness. The role implements short- and long-term plans to resolve revenue integrity edits in Epic within deadlines, support compliant charge capture, ensure timely claim filing, reduce denials, and coordinate with Revenue Cycle departments to manage DNFB and facilitate timely insurance payments. The manager promotes continuous process improvement and sets departmental behavior and performance standards aligned with Ensemble’s Difference principles.

The manager leads revenue integrity work across Ensemble clients, including edit resolution, identification of charge capture trends, and education for clinical staff on charge capture and revenue reconciliation. The position also oversees staffing, hiring, performance management, employee development, training, job standards, policies, and performance appraisals. It uses operational data and analytics to guide decisions, establish goals, improve performance, meet budget and financial objectives, and support customer satisfaction. The manager collaborates with internal and external customers and ancillary departments, participates in strategic planning, and evaluates and implements process and policy improvements.

Requirements

• High school diploma, GED, or equivalent experience.
• CRCR through HFMA, a coding certification or equivalent, or another approved job-relevant certification.
• 5 to 7 years of overall work experience.
• 3 to 5 years of people leadership experience.
• At least 5 years of experience in Revenue Integrity or Revenue Cycle Operations.
• Experience in healthcare operations, Revenue Cycle Operations, charge capture, and billing.
• Required education specialty/major: Business or healthcare field.

Nice To Haves

• Bachelor’s degree, preferably in a business or healthcare field.

Responsibilities

• Manage revenue integrity activities performed by staff across Ensemble clients, including timely resolution of edits so claims can be sent to insurers.
• Identify trends and issues in charge capture, and educate clinical staff on appropriate charge capture and revenue reconciliation processes.
• Collaborate with Revenue Cycle departments to support compliant charging and billing, identify charge capture errors, and provide education for accurate charging and billing.
• Attend and coordinate weekly and monthly department meetings.
• Interview, hire, staff, manage performance, and develop department employees; counsel and discipline employees when necessary under applicable policies.
• Develop and maintain training and education programs for new and existing staff.
• Develop, update, and implement job standards, job duties, departmental policies, and performance appraisals for areas of responsibility.
• Prepare monthly analytics reports as requested by management.
• Set departmental goals with staff to optimize performance, meet budget goals, improve operations, increase customer satisfaction, and meet organizational financial goals.
• Collect, interpret, and communicate performance data using available tools and systems, and use the data to determine how to achieve performance goals.
• Work with internal and external customers on decisions affecting the organization or individual patients.
• Maintain positive relationships with ancillary departments to support revenue cycle goals.
• Assist with strategic planning and conduct ongoing process improvement evaluations.
• Review, update, and implement policies and procedures to support organizational vision and goals.

Benefits

• Comprehensive benefits package, including healthcare, time off, retirement, and well-being programs.
• Professional development and the opportunity to earn a field-relevant professional certification.
• Tuition reimbursement.
• Quarterly and annual incentive programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: High school or GED