Revenue Integrity Manager

Integrated Pain Management Medical Group, Inc.•Walnut Creek, CA

6d•$104,000 - $113,000•Remote

About The Position

The Revenue Integrity Manager is responsible for overseeing and safeguarding the end-to-end revenue integrity framework for Boomerang Healthcare. This role ensures accurate charge capture compliant coding, audit readiness, and regulatory adherence across all states of operations. The Revenue Integrity Manager serves as the subject matter expert for state-specific Workers’ Compensation billing rules, therapy documentation compliance, pain management coding standards, NCCI/CCI edit governance, and external audit preparedness. This is a remote role.

Requirements

Bachelor’s degree in healthcare administration, business, or related field (master’s preferred)
7+ years progressive experience in: Revenue Integrity Coding Compliance Audit Management
Direct experience in Pain Management and Rehabilitation billing, with a strong Workers’ Compensation focus.
CPC, CCS, or CCS-P required
Strong regulatory and payer knowledge
Ability to translate compliance requirements into operational work flows in pain management, workers comp, or procedural-based specialties.
Excellent analytical, communication, and leadership skills.

Nice To Haves

CRC (Certified Revenue Cycle Professional) or CHC (Certified in Healthcare Compliance) Preferred

Responsibilities

Own and manage charge integrity programs across pain management, rehab therapy, and ancillary services.
Perform state-specific Workers’ Compensation charge audits, ensuring compliance with jurisdictional billing rules, fee schedules, and payer requirements.
Monitor and validate charge capture accuracy across: Interventional pain procedures Rehabilitation and therapy services Evaluation & Management services
Identify and mitigate revenue leakage, under-coding, over coding, and duplicate billing risks.
Oversee coding compliance, therapy documentation, including: Plan of care requirements Timed vs. untimed code rules Functional outcome reporting Medical necessity standards
Serve as the escalation point for complex coding determinations and documentation deficiencies.
Own enterprise-wide NCCI and CCI edit governance, including: Edit monitoring and updates Appropriate modifier application Edit override review and approval
Collaborate with billing, coding, and IT teams to ensure accurate system configuration and preventive edit controls.
Analyze edit-driven denials and implement root cause corrections
Develop and maintain revenue integrity dashboards, including: Charge error rates Documentation compliance trends Audit exposure metrics NCCI/CCI denial trends
Present findings and risk mitigation strategies to RCM leadership and executive stakeholders.
Proactively identify high-risk service lines, providers, and states
Assumes other responsibilities as appropriate to the position and organizational needs