Revenue Integrity Manager - Charge Optimization
About The Position
The Revenue Integrity Manager provides strategic leadership for enterprise-wide charge governance, revenue optimization, and Epic revenue cycle configuration across the entire integrated health system. This role oversees Revenue Cycle team members responsible for charge build integrity, chargemaster (CDM) governance, reconciliation controls, denial prevention, system optimization, and regulatory compliance. The Manager ensures that Epic configuration, charging workflows, and CDM structure support compliant, accurate, and timely billing while minimizing revenue leakage and audit risk. This position partners closely with Finance, Coding, Compliance, Patient Access, Billing, Clinical Operations, Informatics, and IT to align system design with financial strategy.
Requirements
- 5+ years in Revenue Integrity, Revenue Cycle, Charge Build, CDM governance, or Healthcare Finance
- 5+ years of leadership experience
- Experience with Epic Resolute (HB/PB)
- Advanced knowledge of CPT/HCPCS, revenue codes, CMS billing regulations, NCCI/MUE edits, charge capture, and payer reimbursement
- Advanced proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook), including advanced Excel skills for data analysis and reporting
Nice To Haves
- CPC, CCS, RHIA, RHIT, CRCR or similar certification
- Epic HB or PB certification
- Experience leading a team through charge standardization initiatives in an integrated health system
- Knowledge of payer contracts and reimbursement methodologies
Responsibilities
- Lead enterprise Revenue Integrity strategy and operational execution
- Establish governance for charge build, CDM maintenance, reconciliation controls, charge capture, and denial prevention
- Ensure CDM standardization, pricing integrity, and regulatory update implementation
- Promote automation to reduce manual work queues and improve reconciliation efficiency
- Maintain compliance with CMS, NCCI, MUE, OPPS/IPPS, and price transparency regulations
- Ensure enterprise charge reconciliation processes and internal controls are in place and monitored
- Drive continuous improvement initiatives to reduce revenue leakage
- Educate operational leaders on charge governance, reconciliation expectations, and regulatory risk
- Manage, mentor, lead team members and serve as escalation point for high-risk revenue cycle issues
Benefits
- medical
- dental
- vision
- life
- disability insurance
- supplemental options
- 401(k) plan with employer contributions
- training
- tuition reimbursement
- educational programs
- flexible scheduling
- generous time off
- wellness resources
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What This Job Offers
Job Type
Full-time
Career Level
Manager
