Revenue Integrity Manager

Hope Network Careers•Grand Rapids, MI

About The Position

Revenue Integrity Manager We are all equally human. Join us. At Hope Network , over 2,800 compassionate professionals serve individuals across 125+ locations statewide—each playing a vital role in creating powerful comebacks. Whether through hands-on care or essential behind-the-scenes support, every team member contributes to a greater purpose: transforming lives. Position Summary Hope Network is seeking a knowledgeable and results-driven Revenue Integrity Manager to lead and optimize revenue cycle operations across the organization. This role serves as a key partner in shaping and improving both front-end patient access and back-end billing and collections processes, working collaboratively with leadership to enhance reimbursement, operational efficiency, and regulatory compliance. This position plays a critical role in coordinating revenue management systems, workflows, and best practices including insurance verification, benefits and eligibility, patient registration, authorizations, point-of-service collections, charge capture and reconciliation, and denial management. Responsibilities also include supporting staff training and education related to billing and collections activities, performance reporting and analysis, effective use of payer portals, and contributing to fee schedule maintenance and payer contract review processes.

Requirements

Bachelor’s degree in Business Administration, Finance, Health Care Administration, Health Information Management or the equivalent of four (4) years of proven success in a medical office / medical billing setting.
Demonstrated knowledge and application of Medicaid, Medicare, Commercial, Auto No Fault and Community Mental Health Payers billing and reimbursement guidelines is required.
Demostrated proficiency in the use of technologies: Microsoft Office, specifically in the use of Excel; insurance eligibility such as CHAMPS, Web-Denis; Availity, etc.
3-5 years of previous supervisory experience.

Nice To Haves

Experience in EHR/EPM systems such as NextGen, athena, EPIC a plus.

Responsibilities

Works collaboratively with Sr Director to ensure the departmental application of best practices and maximizing of operational efficiencies and performance.
Responsible for enhancing insurance verification, authorizations, charge capture, coding review, time of service collections, denials, fee schedules, and contracting processes for efficiency and best practices; ensuring systems are fully functional.
Actively monitors key performance metrics to improve performance of Revenue Management front end processes in collaboration with the total team.
Responsible for personnel development through training, coaching and supervision to include individual and team sessions.
Maintains a high level of technical knowledge and expertise regarding current and pending regulations, legislation, and/or third-party payers and the potential impacts on the billing and collections process/systems used within the Network.
Responsible for the development of proactive relationships with internal and external contacts that will assure the various funder streams are collected in accordance with the established timeframes and guidelines of the contract including bad debts when applicable.
Ensures routine and consistent metric reporting and processing requirements have been completed in a timely manner and are consistent with Network goals and objectives.