Quality and Revenue Integrity Manager

Job Summary

Leading initiatives to ensure accuracy and compliance in hospital revenue cycle processes, the full-time remote Quality and Revenue Integrity Manager will manage revenue integrity programs, conduct audits, and collaborate with clinical and compliance teams to optimize reimbursement and uphold regulatory standards.

Key responsibilities

• Develop and maintain revenue integrity programs to ensure accurate charge capture and mitigate revenue leakage
• Collaborate with HIM and Compliance teams to ensure accuracy of medical records and support proper reimbursement assignments
• Ensure compliance with regulatory requirements and prepare documentation for external audits and reviews

Required qualifications

• 5-8+ years of experience in healthcare revenue cycle, coding, auditing, or compliance
• Strong knowledge of hospital billing processes and applicable code sets (ICD-10, CPT, etc.)
• 3+ years in a leadership or managerial role preferred
• One or more relevant certifications (e.g., RHIA, RHIT, CCS, CPC, CHC)
• Proficiency in healthcare IT systems and advanced skills in Excel for data analysis