WakeMed · 1 month ago
Manager, Revenue Integrity
United States
Full-time
Remote
Mid, Senior Level
5+ years expWakeMed is the leading provider of health services in Wake County, committed to improving the health and well-being of the community. The Manager of Revenue Integrity will provide strategic leadership for the Revenue Integrity Department, ensuring compliance and optimizing reimbursement while leading initiatives across various operational areas.
Health CareHospitalMedical
Responsibilities
Provides strategic leadership and technical oversight for the Revenue Integrity Department
Ensures accurate, complete, and timely charge capture and reconciliation, optimizes reimbursement, and safeguards compliance with all regulatory standards
Leads key operational initiatives across nurse auditing, coding, Charge Description Master (CDM) maintenance, and denials management, while fostering collaboration with clinical, financial, and operational teams
Through innovative strategies and continuous process improvement, this position enhances revenue cycle performance and supports organizational financial health
Supervise and mentor the Revenue Integrity teams, including nurse auditors, coders, analysts and specialists
Monitor performance metrics and implement continuous improvement strategies
Conduct performance evaluations and support professional development for direct reports
Oversee the development and execution of revenue integrity initiatives to optimize charge capture and reimbursement
Manage EHR Revenue Cycle systems and other billing platforms to ensure accurate and timely charge capture
Direct and support CDM maintenance and revenue integrity analytics, to include collaboration with managed care team and finance for pricing oversight
Research, evaluate, and interpret regulatory and payor guidance to assess facility impact, ensuring compliance and maximizing revenue performance
Monitor and evaluate billing and coding updates impacting CDM and Charge capture processes to ensure accurate claim submission, appropriate distribution of information, and identify opportunity areas for education
Ensure adherence to federal, state, and payor-specific regulations, lead internal audits and process reviews to identify revenue leakage and compliance risks
Collaborate with clinical, financial, and operational stakeholders to ensure alignment and compliance with regulatory requirements
Develop, execute, and manage denial prevention and resolution strategies
Provide actionable analytics and key performance indicators (KPI's) to executive leadership, driving alignment with financial objectives and identifying opportunities for improvement
Engage and collaborate with clinical and ancillary leadership to drive charge capture excellence by monitoring KPIs, implementing process improvements, proactively managing denial and audit risks, and delivering targeted education that supports organizational revenue integrity
Serve as a liaison for denials and avoidable write-off committee
Develop operational policies, procedures, and training documentation for the Revenue Integrity efforts with organizational priorities
Promote and emulate a patient-centric and customer service-oriented culture
Represent the department in community and agency events as appropriate
Qualification
Required
Bachelor's Degree Healthcare Or Accounting Or Finance
3 Years Leadership
1 Year Project Management
5 Years Healthcare
Preferred
Certified Professional Coder
Registered Health Information Administrator
Certified Coding Specialist
Registered Health Information Technician
Project Management Professional
7 Years Health Information Management
7 Years Accounting/Finance - Revenue Cycle
Company
WakeMed
WakeMed Health & Hospitals is a private, not-for-profit health care organization based in Raleigh, N.C.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Christine Craig
VP, Government Affairs
Thomas G. Cavender
VP Facilities and Construction
Recent News
2025-09-22
Fierce Healthcare
2025-07-22
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