Manager of Revenue Integrity

Job Summary :

The Revenue Integrity Manager is responsible for overseeing the entire day to day operations of the Central Billing Office staff within a healthcare or related organization. This includes managing the processes of patient billing, claims management, coding, collections, and insurance follow-up. The role ensures that all financial operations related to patient and insurance billing are efficient, compliant, and align with organizational goals.

Key Responsibilities :

• Revenue Cycle Oversight : Manage the entire revenue cycle process from patient registration through to final payment, ensuring maximum efficiency and compliance with regulatory standards.
• Billing and Coding : Supervise billing and coding departments to ensure accurate and timely claims submission to insurance companies and third-party payers.
• Claims Management : Oversee and ensure accurate, timely follow-up on claims, addressing denials, and appeals as needed to optimize reimbursement.
• Collections : Oversee collection activities, ensuring that outstanding balances are followed up on and resolved promptly.
• Staff Management : Recruit, lead, train, and develop a team of revenue cycle professionals, ensuring high levels of performance and engagement.
• Compliance : Ensure that all revenue cycle operations comply with federal and state regulations, as well as industry standards such as HIPAA and ICD-10.
• Process Improvement : Identify and implement strategies to streamline revenue cycle processes, reduce errors, and improve cash flow. Document and revise processes as needed.
• Collaboration : Work closely with clinical, operational, and financial departments to ensure efficient revenue cycle operations and address any operational challenges.

Qualifications :

Preferred Skills :