Revenue Cycle Integrity Manager

Wabash General Hospital•Mt Carmel, IL

1d•$31 - $39

About The Position

The Revenue Cycle Integrity Manager is responsible for leading and coordinating efforts to ensure accurate, compliant, and optimized reimbursement throughout the revenue cycle. This position serves as the organizational leader for revenue integrity initiatives including denial prevention, charge capture validation, reimbursement analysis, payer compliance, documentation improvement, prior authorization compliance, audit management, and revenue cycle performance improvement.

Requirements

Bachelor’s degree in healthcare administration, finance, business, or related field.
Minimum ten years of healthcare revenue cycle experience.
Knowledge of healthcare reimbursement, CPT, HCPCS, ICD-10, MS-DRG, APCs, chargemaster maintenance, denial mitigation, payer compliance, and regulatory requirements.
Strong analytical, financial, project management, and leadership skills.

Nice To Haves

Preferred certifications include RHIA, RHIT, CCS, CPC, CDIP, or CHRI.

Responsibilities

Lead the Revenue Integrity Program and identify opportunities to reduce revenue leakage.
Analyze denial trends and implement corrective action plans.
Conduct charge capture audits and monitor charging accuracy.
Manage Chargemaster governance, updates, and compliance reviews.
Review payer contracts and reimbursement methodologies.
Monitor prior authorization compliance and reduce authorization-related denials.
Partner with HIM, Coding, Billing, Central Scheduling and Clinical Leadership to improve documentation quality.
Coordinate responses to payers, RAC, and other reimbursement audits.
Develop dashboards and revenue cycle integrity performance reports.
Lead cross-functional quality improvement projects throughout the revenue cycle.

Benefits

Health Insurance (Medical, dental, and vision coverage options)
Free internal prescription program
Employer contributions to premiums
457(b) plan with employer matching
401(a) plan for employer contributions
Vacation days: 12 to 27 days per year based on years of service
Sick days: 12 days per year accruing to a maximum of 65 days
6 observed paid holidays
Flexible work schedules
Employer-provided life insurance with optional additional coverage available at the employee's expense
Short-term and long-term disability insurance
Employee assistance programs (EAP)
Health Savings Accounts
Flexible Spending Accounts
Professional development opportunities
Scholarship and Tuition reimbursement
Wellness programs
Volunteer opportunities
Productivity, retention, and referral bonuses