Prime Healthcare · 1 day ago
Manager of Revenue Integrity Compliance
Ontario, CA
Full-time
Onsite
Senior Level
$98K/yr - $141K/yr
7+ years expPrime Healthcare is an award-winning health system headquartered in Ontario, California. The Revenue Integrity Compliance Manager will lead and oversee the organization’s Revenue Integrity and Charge Description Master compliance initiatives, ensuring adherence to federal and state financial reporting requirements.
Health CareHospital
Responsibilities
Develop, implement, and manage the Revenue Integrity & CDM Compliance Plan
Ensure compliance with CMS Price Transparency Rule and other applicable federal and state financial reporting regulations
Collaborate with cross-functional teams including Health Plan Operations, Patient Access, Marketing, IT, and Legal to streamline compliance processes
Design and execute weekly/monthly audit plans for compliance-related reporting activities
Coordinate with hospital end users and offshore teams to ensure accurate and timely deliverables
Lead the development and implementation of process automation tools to enhance compliance efficiency
Generate and distribute weekly/monthly compliance reports to stakeholders
Monitor regulatory changes and update internal policies and procedures accordingly
Qualification
Required
Bachelor's degree in Healthcare Administration, Finance, or a related field of study is required (Combination of education and experience is also acceptable)
Minimum seven (7) years of experience in healthcare revenue cycle operations is required
Minimum three (3) years of experience in leading a revenue cycle function is required
Prior experience in interpreting different claim forms and remittances is required
Understanding of patient insurance benefit is required
Experience working with payers including Medicare, Medicaid, and commercial insurance is required
Understanding of CPT's, HCPCs, Diagnosis code, DRG code, EAPG, revenue code, etc. is required
Understanding of payor payment methods viz. Fee Schedule, RCC, Case rate is required
Preferred
Experience working with Contract Management and Patient Access is preferred
Prior experience working with EPIC and Meditech preferred
Benefits
Paid time off
A 401K retirement plan
Medical, dental, and vision coverage
Tuition reimbursement
Many more voluntary benefit options
Company
Prime Healthcare
About Prime Healthcare and Prime Healthcare Foundation: Prime Healthcare is an award-winning health system operating 51 hospitals and more than 360 outpatient locations in 14 states, providing over 2.5 million patient visits annually.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$1.5B2024-09-04Debt Financing· $1.5B
Leadership Team
Luis Leon
Chief Operating Officer, Chief Executive Officer Region VI
Recent News
2025-11-19
Morningstar.com
2025-11-15
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