CDI Revenue Integrity Manager

• Direct Hire
• Remote
• $87-$100k+ starting salary

Provides leadership and day-to-day operational management for revenue integrity functions, focusing on clinical documentation improvement (CDI) to prevent revenue leakage and enhance potential revenue across the system. Manages CDI efforts, Charge Description Master (CDM) maintenance, root cause analysis, and denials coordination, including complex case denials and denial prevention. Directs audits, education, and training for multidisciplinary hospital teams to strengthen documentation and optimize revenue capture. Oversees revenue optimization, charge control processes, and staff performance by implementing process improvements, policies, continuing education, and professional development activities.QUALIFICATIONS

• Three to five years of recent experience in revenue cycle, patient accounting, health information management, or physician billing, ideally in an academic or large healthcare setting.
• Coding certification required (CPC preferred, but other certifications considered).
• Preferred: Epic PB Proficiency, Revenue Guardian certification, and experience in CDI and/or CDM maintenance.

EDUCATION AND EXPERIENCE

• Bachelor's degree in Business, Finance, Healthcare, or a related field required.
• Minimum three years of management experience in a multi-facility healthcare delivery system or revenue cycle consulting.
• Strong knowledge of appeals, denials management, medical necessity, and coding.

LICENSES, REGISTRATIONS, CERTIFICATIONS

• Coding certification required, CPC preferred but other coding certifications are considered.

OTHER SKILLS AND ABILITIES

• Strong analytical skills, problem-solving abilities, and judgment to make informed decisions.
• Proficiency in learning and using relevant computer systems effectively.

WORK ENVIRONMENT

• Typically performed in a clean, well-lit, temperature-controlled environment with moderate noise.

PHYSICAL DEMANDS

• Occasionally required to stand and use hands for handling or feeling; must occasionally lift/move up to 10 pounds and have close vision capabilities.

INTERPERSONAL REQUIREMENTS

• Requires daily verbal and written communication with management, clinicians, and colleagues in the revenue cycle.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Lead and oversee all Revenue Integrity team functions, including analytics, reporting, and communication with departments and external stakeholders.
• Manage and drive CDI efforts system-wide, implementing continuous learning for key providers.
• Identify targeted revenue improvement opportunities and assess financial impacts in clinical departments.
• Collaborate with Revenue Cycle leadership to prioritize initiatives, monitor performance, and set Key Performance Indicators (KPIs) for revenue integrity.
• Develop and implement policies, tools, and educational materials for Revenue Integrity.
• Direct the Charge Review program to improve charge capture and reduce revenue leakage.
• Facilitate strong relationships and communications with Revenue Cycle stakeholders and support departments.
• Oversee denial management audit processes, trend identification, and prevention/recovery programs.
• Ensure consistent tracking and reporting on financial and operational performance for Revenue Integrity and denial management.
• Demonstrate working knowledge of billing, collection, and charge processes, and stay informed of industry best practices.
• Strong skills in leadership, delegation, communication, and interpersonal relations.
• Effective time management skills to handle a high-volume workload.
• Utilize data analytics for trend identification in Denial Management and Write-Off Prevention, collaborating with departments to enhance future prevention strategies.