Revenue Integrity Team Lead

University of Chicago•Burr Ridge, IL

5d•$80,000 - $105,000•Onsite

About The Position

University of Chicago Physicians Group (UCPG) is seeking a Revenue Integrity Team Lead to assure that UCPG achieves the objective of CMS coding guidelines and adheres to the compliance program of the Medical Center. The Revenue Integrity Team Lead provides support to providers and clinic staff for CPT, ICD-10-CM, and HCPCS coding systems, and acts as a liaison between the off-sites and departments and related educational activities around coding, billing and compliance. This role uses best practices and knowledge related to revenue cycle operations, including activities related to charging, billing, and collecting. Coordinates the management of successful billing and compliance activities with department managerial and executive staff. The Revenue Integrity Team Lead serves as a key leader within revenue cycle operations, responsible for advancing coding accuracy, documentation integrity, and overall revenue performance. This role provides strategic oversight of coding education, denial management, and revenue integrity initiatives, ensuring alignment with organizational goals, compliance standards, and regulatory requirements. In addition to education and audit responsibilities, this role will lead and manage coding denial operations, including oversight of offshore vendor teams responsible for daily work queue management. The Team Lead will ensure accurate, timely resolution of coding denials, drive process improvements, and implement strategies to enhance first-pass claim acceptance and maximize reimbursement. The qualified individual will work to achieve overall revenue cycle expectations that comply with larger UCPG organizational goals and Compliance Department expectations, as well as utilize project and people management skills, clinical practice knowledge, and an understanding of documentation and coding requirements to support improvement in practice processes and compliance.

Requirements

College or university degree in related field.
Knowledge and skills developed through 5-7 years of work experience in a related job discipline.

Nice To Haves

Bachelor's degree.
Four to five years demonstrated knowledge of coding.
Two years experience in medical record chart documentation review.
Two years experience in group education with provider audiences.
One year working with Epic PB Resolute/EpicCare.
Certified Professional Coder (AAPC) or Certified Coding Specialist-Physician based (AHIMA).
Understanding of physiology, medical terminology, and disease process.
Advanced E/M coding experience and explain coding guidelines.
Proficient in PC skills including Microsoft Excel, Power Point, Microsoft Access, and Word.
Extensive knowledge of health information systems and database technology.
Create compliant documentation, coding-based curriculum, and training materials.
Possess basic computer skills.
Strong analytical, problem-solving, interpersonal, verbal/written communication, organizational, project management and team development skills.
Deliver effective oral presentations and prepare concise written reports for a variety of audiences.

Responsibilities

Leads end-to-end management of coding-related denial work queues, ensuring timely and accurate resolution.
Oversees offshore/vendor teams responsible for daily denial work queue execution, including productivity, quality, and performance management.
Performs routine quality assurance (QA) reviews of vendor work to ensure denials are worked accurately, compliantly, and effectively.
Establishes performance metrics, monitor KPIs, and holds vendors accountable for turnaround times, accuracy, and outcomes.
Ensures denial work queues are actively worked daily, maintained at appropriate volumes, and free of aging or inactive accounts.
Develops and implements strategies to reduce coding-related denials and improves first-pass claim acceptance rates.
Identifies opportunities to enhance reimbursement and increase net collections through denial prevention and resolution strategies.
Analyzes denial trends and root causes to drive process improvements and upstream corrections.
Partners with billing, coding, and clinical teams to address systemic issues impacting revenue.
Identifies and executes targeted audit opportunities based on denial trends and risk areas, in addition to other revenue integrity related needs.
Conducts coding and documentation audits with actionable feedback to providers and staff.
Utilizes data analytics tools, including Excel, to track denial patterns, performance trends, and financial impact.
Develops and delivers coding and documentation education to physicians, faculty, departments, and staff.
Creates training materials and leads educational sessions focused on improving documentation, coding accuracy and reducing denials.
Acts as a subject matter expert for CPT, ICD-10-CM, and HCPCS coding guidelines.
Prepares and delivers regular presentations on denial trends, team performance, and revenue impact to leadership.
Organizes and presents executive-level updates on coding performance, denial reduction progress, and key initiatives.
Communicates findings, risks, and opportunities clearly to stakeholders across departments.
Ensures ongoing oversight and regular updates of the revenue integrity project plan.
Monitors coding workflows, documentation practices, and billing processes to ensure compliance and efficiency.
Serves as a liaison between clinical departments, coding teams, and revenue cycle leadership.
Ensures adherence to CMS, payer, and organizational compliance standards.
Directly supports and contributes to broader Professional Billing Revenue Integrity Unit initiatives to ensure comprehensive revenue cycle health.
Leads and supports revenue integrity initiatives and cross-functional projects as assigned.
Maintains responsibility for broader revenue integrity functions, ensuring alignment with organizational priorities.
Remains actively engaged in ongoing and new projects related to coding, compliance, and revenue cycle optimization.
Maintains coding credentials and stays current with regulatory and industry changes.
Performs other revenue integrity and related duties as assigned.
Has a deep understanding in the areas of chart documentation and maintaining requirements within the department. Ensures all processes involved in accurately posting professional fees.
Has a deep understanding of coding procedures, workflow issues, billing infrastructure, and performance of Clinical Revenue staff. Informs department administrators, physicians, and Coder/Abstractors of regulatory changes.
Guides departmental compliance efforts by participating in training sessions, performing audits, and promoting an understanding of procedures, policies, and expectations
Performs other related work as needed.