Manager Revenue Integrity - FT - Days - MHS - Remote Eligible

Memorial Healthcare

11d

About The Position

The Revenue Integrity Manager provides operational leadership for Revenue Integrity functions, overseeing staff and workflows to ensure accurate, compliant, and timely charge capture, billing readiness, reimbursement optimization, and revenue protection across Memorial Healthcare System (MHS). The manager leads the Revenue Integrity Charge Capture and Reconciliation team and works with clinical and operational departments, analysts, coding, billing, and application teams to support compliant revenue-cycle processes. The role reviews revenue, utilization, charge master accuracy, denial trends, reimbursement updates, work queues, and billing edits to identify opportunities, assess financial impacts, address root causes, and improve performance. It oversees charge-capture controls, charge-related Epic work queues, new procedure implementation, CPT/HCPCS updates, fee schedule updates, and price-transparency files. The manager also develops training and educational materials, manages application projects and system enhancements, and implements process improvements in alignment with regulatory requirements and organizational initiatives. The position requires a bachelor's degree in Finance or a related field, at least five years of functional/core experience with hospital billing systems or medical billing—specifically Epic—and at least five years in a supervisory or leadership capacity. Epic Charge Router or Epic Resolute Billing certification is listed in the posting, while the qualifications section identifies these and several coding or health-information credentials as preferred. The job is listed as full-time, days, and remote eligible. Its working-conditions section describes a range of physical activities and exposures, with percentages provided for each.

Requirements

Bachelor's degree in Finance or a related field.
At least 5 years of functional/core experience in hospital billing systems or medical billing, specifically using Epic software.
At least 5 years of experience in a supervisory or leadership capacity.
Expert knowledge of Epic revenue-integrity tools, including Charge Records (EAP), Charge Router/Charge Handler, and Revenue Guardian, and the ability to design, implement, and oversee related controls.
Working knowledge of CPT, HCPCS, and ICD-10 coding systems and their use in healthcare billing, reimbursement, and regulatory compliance.
Critical-thinking and analytical skills, including the ability to evaluate complex situations, identify solutions, and make sound business decisions.
Strong verbal and written communication skills and ability to collaborate with diverse stakeholders.
Ability to exercise independent judgment and discretion in managing priorities and operational challenges.
Ability to work autonomously with minimal supervision and maintain accountability and performance.
Ability to work effectively in a fast-paced, dynamic environment and respond to changing priorities and business needs.
Strong problem-solving skills and ability to take timely and appropriate action in high-pressure situations.

Nice To Haves

Epic Charge Router Certification (EPIC CHG ROUTER).
Epic Resolute Billing Certification (EPIC BILLING).
Certified Professional Coder-Hospital (CPC), American Academy of Professional Coders (AAPC).
Certified Coding Specialist (CCS), American Health Information Management Association (AHIMA).
Registered Health Information Technician (RHIT), American Health Information Management Association (AHIMA).
Registered Health Information Administrator (RHIA), American Health Information Management Association (AHIMA).

Responsibilities

Manage daily functions of the Revenue Integrity Charge Capture and Reconciliation team.
Manage staffing activities, including hiring, orientation, evaluation, disciplinary actions, and continuing education.
Test samples of departmental charges to assess staff performance and the effectiveness of controls; coordinate retraining and periodic updates for charge-capture staff.
Provide application and end-user training, support, and troubleshooting.
Manage application projects, including workflow analysis, end-user validation, acceptance, go-live, maintenance, deadlines, deliverables, debugging, and enhancements.
Analyze billing, coding, and documentation requirements for payer coverage and payment, and advise MHS leaders on their effects on service lines and initiatives.
Design and evaluate departmental charge-capture tools and processes; improve tools and controls so charges are accurate and timely and avoid rework.
Ensure Epic charge-related work queues are cleared correctly and on time.
Identify and implement technology-enabled process improvements aligned with organizational strategic initiatives.
Plan application development and deployment, and promote adherence to organizational software compliance standards.
Identify opportunities to improve charge-capture efficiency and accuracy, prevent missed charges and billing rework, and improve net revenue, using regulatory updates, strategic initiatives, and user feedback.
Monitor and analyze Medicare, Medicaid, and other technical guidance; develop, recommend, and implement compliance plans as approved by the Director of Revenue Integrity and in collaboration with MHS leaders.
Develop annual CDM CPT/HCPCS updates, coordinate with departments to identify applicable new or revised codes, and oversee maintenance of CDM-driven coding requirements.
Develop annual CDM fee schedule updates and update the Price Transparency Standard Charges file in accordance with regulatory requirements.
Review revenue, utilization, charge master accuracy, and denial trends to identify revenue-cycle optimization and charging-compliance opportunities.
Educate clinical departments on charging requirements and revenue-integrity practices; collaborate with analysts, coding, billing, and operational teams.
Lead revenue-management activities for areas owned by Revenue Integrity, including charge-capture oversight and process-improvement initiatives.
Analyze payer reimbursement updates and provide financial impact assessments and recommendations to leadership.
Oversee new procedure implementation, including CPT code assignment, preference-list updates, and clinical department education.
Develop and monitor processes to reduce late charges, support timely billing, and improve revenue-cycle outcomes through dashboard and report analysis.
Monitor work queues, identify root causes of revenue-cycle issues, and implement corrective actions, process improvements, training, and ongoing monitoring.
Evaluate charge edits, pre-bill edits, National Correct Coding Initiative edits, and Medically Unlikely Edits for compliance and accurate revenue capture.
Develop educational materials, including presentations, tip sheets, and job aids, covering charge-capture workflows, revenue-cycle processes, and system enhancements.