Revenue Integrity Manager
On-site · Corona, California, United States
Job Summary
The Revenue Integrity Manager is responsible for overseeing revenue validation and financial integrity processes to ensure accurate net patient revenue, regulatory compliance, and optimal reimbursement performance. This role analyzes financial, billing, and operational data to identify revenue gaps and underpayment trends, supports month-end close and revenue reporting, and collaborates with clinical departments to optimize reimbursement outcomes. Requires a Bachelor's degree in a related field, at least 5 years of hospital revenue cycle experience, and strong knowledge of CDM maintenance and reimbursement methodologies.
Required Qualifications
- Bachelor’s degree in healthcare administration, Finance, Accounting, Business, or related field (Master’s preferred).
- Minimum 5 years of progressive hospital revenue cycle experience.
- Strong knowledge of CDM maintenance, AR valuations, NRV, reimbursement methodologies, and payer regulations.
- Experience with hospital billing systems and EHR platforms.
- Knowledge of CPT, ICD-10, and HCPCS coding structures.
- Strong analytical and problem-solving skills.
Desired Qualifications
- HFMA (CRCR, CHFP), CCS, CPC, or CPA certification preferred.
- Experience in multi-facility health systems.
- Experience with revenue cycle analytics and reporting dashboards.
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