Fairview Health Services · 3 weeks ago
Manager- Revenue Integrity
United States
Full-time
Remote
Mid, Senior Level
3+ years expFairview Health Services is looking for a Manager- Revenue Integrity to join their team. This role is responsible for the leadership, development, coordination, implementation, and oversight of Revenue Integrity functions, ensuring compliant and efficient charge capture across the system.
AssociationHealth CareHospitalMedical
Responsibilities
Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures, and standards. Provides oversight to ensure compliance with established laws, regulations, practices, and procedures
Responsible for providing the operational oversight for system-wide charge capture activities. Provides operational direction for Charge Capture integrity, aligning direction with customer expectations, financial expectations, environmental requirements, and organizational objectives. This includes:
The analysis of department charges
The identification and implementation of charge improvement strategies
Assisting departments with their charge capture activities, including the development of charge reconciliation processes where needed
Sets, oversees, and ensures daily operations, service support and outcomes are performed timely and accurately in accordance with regulatory and payer requirements
Designs and helps maintain workflows to ensure efficient and effective processes, monitors and prioritizes work based on organizational needs and assignments, and appropriately assures timely, productive, and efficient use of resources
Ensures work assignments are performed and supported to achieve departmental goals and outcomes
Ensure staff members are knowledgeable about revenue assurance needs and reimbursement issues identified through audits, reviews, and aggregate data analysis
Ensures key productivity and quality standards for department processes are adhered to and managed appropriately
Develops and tracks key performance indicators (KPIs) to monitor revenue integrity trends, communicate outcomes to leadership, and drive continuous improvement and achieve industry-level benchmarks for the department and team
Selects, hires, orients, and trains qualified employees to perform job responsibilities, mentors and evaluates staff
Develops and implements a formalized system-wide charge capture education plan including execution strategy and routine updates as needed
Leverages analytics, audits, and charge reconciliation data to identify missing, miscoded, or unbilled charges, as well as underutilized CDM items; collaborates with operational and financial leaders to implement corrective actions and prevent recurrence
Tracks and assesses integrity risks, and ensures the revenue integrity program is responsive to those risks, activates additional financial controls as appropriate and follows through to resolution
Leads and/or actively participates in committees addressing and/or is responsible for revenue integrity root cause and resolution activities
Partners with clinical and operational departments to translate charge capture findings into process improvements, workflow changes, and system optimization to ensure accurate use of CPT/HCPCS codes, modifiers, and revenue codes
Serves as the primary liaison between Revenue Integrity and operational leaders for charge capture, pricing, and reimbursement integrity initiatives
Facilitates cross-functional meetings to review trends, identify systemic risks, and develop corrective or optimization programs
Establishes escalation pathways and feedback loops to ensure charge capture and pricing issues are prioritized and resolved in collaboration with Finance, Clinical Operations, and IT
Provides routine performance reports regarding the nature, progress, and status of the revenue integrity program, any course correction being taken, and any recommended changes
Provides technical expertise, troubleshooting issues, and input on improvement projects and product selection
Identifies, evaluates, coordinates, and implements tactics to achieve organizational objectives, improve operational efficiencies, and increase positive cash flow
Leads the enhancement of charge description master (CDM) activities and supports maintenance of integrated revenue cycle applications, reviewing and optimizing organizational CDM structures to ensure all services and supplies are reflected accurately and are consistent with current industry best practices. Include clearly stated service level agreements and accountability for updates by all stakeholders
Fosters a culture of improvement, efficiency and innovative thinking
Monitors, evaluates, and manages department Budget by RCM leadership to achieve budget
Leads or participates in work with peers and other departments to create an excellent understanding of workflows and interdependencies, and to identify and implement strategies to improve revenue cycle performance
Works collaboratively with vendors to assure performance expectations are being met
Represent Revenue Cycle and Fairview Health Services at industry forums to network and identify process improvement opportunities
Serves as a resource on revenue cycle issues and regulatory expectations
Creates strong collaborative partnerships and influences others across teams, groups, and business boundaries to achieve real-world problem solving
Demonstrates ability to provide care or service, adjusting approaches to reflect developmental level and cultural differences of population served. o Partners with patient caregiver in care/decision making. o Communicates in a respective manner. o Ensures a safe, secure environment. o Individualizes plan of care to meet patient needs. o Modifies clinical interventions based on the population served. o Provides patient education based on an assessment of learning needs of patient/caregiver
Fulfills all organizational requirements. o Completes all required learning relevant to the role. o Complies with and maintains knowledge of all relevant laws, regulations, policies, procedures, and standards
Fosters a culture of improvement, efficiency, and innovative thinking
Performs other duties as assigned. o Completes all required training and learning activities relevant to the role. o Maintains up-to-date knowledge of applicable laws, regulations, policies, and procedures
Qualification
Required
Bachelor of Science in Business Administration, Health Care Administration or related area PLUS 2 years of experience in health care reimbursement, financial management or coding OR an approved equivalent combination of education and experience
Thorough knowledge of functions assigned
Thorough knowledge of computer systems used by assigned revenue cycle team
Knowledge of applicable regulatory requirements
Knowledge and understanding of hospital revenue cycle operations (registration, charge capture, health information management, claims, payment posting)
Ability to present to small and large groups
Consistent demonstration of excellent written and verbal communication skills
Proficiency in Microsoft Office: Word, Excel, Power-Point, Visio, Teams, SharePoint and Outlook
Performance improvement, project management and/or lean skills
3 years Applicable leadership business-related experience
One or more of the following: RHIA, RHIT, CHRI, CCS, CPC, CCS, CPC, CCS-P, RN, or
Epic Resolute Certification(s) in one or more of the following Epic applications: Resolute Professional Billing, Resolute Hospital Billing, Claims or
Ability to achieve within one year of employment
Preferred
Masters of Healthcare Admin in Business Administration, Health Care Administration, Nursing, Education or related area
5 years Experience in coding, clinical documentation improvement (CDI), revenue integrity, quality, or a directly related functional area of work
One or more of the following: RHIA, RHIT, CHRI, CCS, CPC, CCS, CPC, CCS-P, RN, and
Epic Resolute Certification(s) in one or more of the following Epic applications: Resolute Professional Billing, Resolute Hospital Billing, Claims
Benefits
Medical
Dental
Vision plans
Life insurance
Short-term and long-term disability insurance
PTO and Sick and Safe Time
Tuition reimbursement
Retirement
Early access to earned wages
Company
Fairview Health Services
Fairview Health Services is a nonprofit healthcare organization that provides various medical and wellness services.
10001+ employees
H1B Sponsorship
Fairview Health Services 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 (5)
2023 (3)
2022 (9)
2021 (7)
2020 (5)
Funding
Current Stage
Late StageTotal Funding
unknown2022-11-15Acquired
Leadership Team
James Hereford
President and CEO
Joe Gaylord
Executive Vice President & Chief Financial Officer
Recent News
2025-12-17
Twin Cities Business
2025-12-09
2025-11-23
Company data provided by crunchbase