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Conifer Health Solutions · 2 weeks ago

Revenue Integrity Manager- Remote

United States

Full-time

Remote

Senior Level

$82K/yr - $123K/yr

5+ years exp

Conifer Health Solutions is a healthcare organization with over 30 years of industry expertise. The Revenue Integrity Manager oversees professional staff responsible for managing charge capture initiatives and ensuring revenue protection, while also facilitating education and compliance with regulatory directives.

Health Care

H1B Sponsor Likely

Responsibilities

Serves as a resource and in a consultative role to various levels of customers; works closely and collaboratively with other internal departments

Manages a professional team to evaluate, review, plan, implement, and report various revenue management strategies to ensure CDM integrity; to identify charge capture improvement opportunities; resolve billing edits and to facilitate appropriate education

Evaluates and maintains workflow processes to ensure efficiencies; works with all personnel involved in the revenue cycle to optimize CDM interfaces, billing edit resolution and charge capture processes

Researches, evaluates, and interprets guidance from a variety of sources to determine department and/or facility impact and to ensure optimal revenue management; continually reviews and monitors billing and coding changes affecting CDM and charge capture processes to ensure accurate claims production, appropriate distribution of information, and to identify target areas for education

Provides incident management and problem resolution; views incidents and problems from a systemic perspective to determine enterprise-wide solutions; oversees implementation of recommendations and monitors results to prevent recurrence; investigates complex issues as required

Manages/oversees special projects and special studies as required for new clients, system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, or other projects including, but not limited to:

Oversees pricing initiatives such as strategic pricing, across-the-board increases, tiered pricing, pricing transparency; conducts interim pricing reviews and performs financial analyses for strategic initiatives

Manages implementation of CDM and/or charge capture corrective measures and monitoring tools to ensure sustainability of changes; reviews and monitors statistics and key performance indicators to identify improvement opportunities and ensure compliance with regulatory/non-regulatory directives

This position may be required to monitor and explain expense variances to budget on a regular basis

This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems

Qualification

Charge Description Master (CDM)Revenue managementHealthcare financial experiencePrior supervisory experienceRegulatory complianceData analysisInterpersonal communicationProblem resolutionConsulting experienceMS Office proficiencyHealthcare industry knowledgeClinical/order entry systemsPresentation skillsAdaptabilityTeam management

Required

Bachelor's degree or higher; related experience may be considered in lieu of degree

Prior supervisory experience required

Minimum of five years healthcare-related experience required

Working knowledge of laws and regulations pertaining to healthcare industry required

Prior healthcare financial experience or related field experience in a hospital/integrated healthcare delivery system required

Prior CDM or charge capture experience required

Strong interpersonal communication and presentation skills, effectively presenting information to executives, management, facility groups, and/or individuals

Ability to present ideas effectively in formal and informal situations; conveys thoughts clearly and concisely

Ability to respond in a professional manner to complex inquiries from various levels of personnel

Accepts personal responsibility for the quality and timeliness of his/her work; establishes due dates for projects and assignments and meets those dates; efficiently organizes activities

Ability to define problems, collect data, establish facts, draw valid conclusions, and make recommendations for improvement

Adapts easily to changing conditions and work responsibilities; works well with people of vastly differing levels, styles, and preferences

Understands external and internal drivers affecting revenue management

Ability to read, review, analyze, and interpret a variety of state/federal regulatory information and managed care contracts and the affect on appropriate claims production including multiple patient accounting systems, clinical/order entry systems, ancillary systems, and CDM

Ability to utilize and research various published resources, appropriate reference materials, Internet resources, seminars, and other associated information sources to continually stay abreast of changes in regulatory information

Working knowledge in MS Office Applications (Excel, Word, Access, Power Point)

Preferred

Consulting experience a plus

Applicable clinical or professional certifications and licenses such as LVN, RN, RT, MT, RPH, CPC-H, CCS highly desirable

Benefits

Medical, dental, vision, disability, life, and business travel insurance

Management time off (vacation & sick leave) – min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked.

401k with up to 6% employer match

10 paid holidays per year

Health savings accounts, healthcare & dependent flexible spending accounts

Employee Assistance program, Employee discount program

Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.

For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.

Company

Conifer Health Solutions

Glassdoor2.8

Conifer Health Solutions is a healthcare services company helping organizations strengthen their financial performance

Founded in 2008

Frisco, Texas, USA

10001+ employees

http://coniferhealth.com/

H1B Sponsorship

Conifer Health Solutions has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (5)

2024 (3)