Revenue Integrity Manager
Chesapeake, VA - USA
Job Summary
- Provide leadership and supervision to the Revenue Integrity and/or CDM team.
- Ensure effective collaboration between providers coders and billers to support compliant documentation and optimal coding outcomes.
- Collaborate with clinical providers to enhance documentation quality and accuracy supporting compliant billing appropriate risk stratification and accurate Uniform Data System (UDS) reporting.
- Conduct routine internal audits and chart reviews to monitor accuracy identify trends and implement corrective actions supporting compliance and data integrity.
- Maintain current knowledge of federal state and payer coding regulations and update internal protocols and workflows to ensure compliance and operational consistency.
- Monitor productivity accuracy and quality metrics; develop and implement performance improvement plans to meet departmental and organizational benchmarks.
- Collaborate with billing clinical quality and compliance teams to enhance communication improve documentation workflows and ensure alignment between coding practices and organizational goals.
- Review high-volume accounts assigned to Revenue Integrity work queues for charge review and charge entry including observation accounts procedure carve-out reviews extended recovery carve-out time injection and infusion charges and related activities.
- Analyze inpatient and outpatient records for appropriate charging coding reviews (NCCI edits MUE edits medical necessity edits) and denials.
- Serve as a resource to hospital departments regarding charging questions audits billing issues and educational opportunities.
- Maintain established productivity requirements and a 95% or greater accuracy rate.
- Revenue Integrity Specialist
- RN Auditor
- Hiring onboarding training and developing team members
- Performance management coaching and employee evaluations
- Scheduling and workforce planning
- Employee relations and corrective action administration
- Work allocation and prioritization
- Budget planning and departmental resource management
- Policy enforcement and compliance oversight
- Ensuring a safe and secure work environment
- Three (3) years of management experience within Revenue Cycle Acute Care or Health Information Management required.
- Five (5) years of revenue analysis charging auditing or coding experience in an acute care setting required.
- Masters Degree
- Candidates with a nursing degree must maintain an active unrestricted nursing license and/or obtain a Certified Professional Coder (CPC) credential within six (6) months of hire.
- Candidates with education or degrees in other disciplines must obtain a CPC credential within six (6) months of employment.
Required Experience:
Manager
About Company
Chesapeake Regional Healthcare is a health system laser-focused on innovation, known for making medical history in the region and providing patients with truly personal care. Its hospital, Chesapeake Regional Medical Center, is the only independent, community-based acute care hospital ... View more