Boomerang Healthcare · 18 hours ago
Revenue Integrity Manager
United States
Full-time
Remote
Senior Level
$104K/yr - $113K/yr
7+ years expBoomerang Healthcare is a multidisciplinary healthcare provider focused on treating pain. The Revenue Integrity Manager oversees the revenue integrity framework, ensuring compliance with billing rules and coding standards while managing charge integrity programs and collaborating with various teams.
Health CareHospitalMedical
Responsibilities
Own and manage charge integrity programs across pain management, rehab therapy, and ancillary services
Perform state-specific Workers’ Compensation charge audits, ensuring compliance with jurisdictional billing rules, fee schedules, and payer requirements
Monitor and validate charge capture accuracy across:
Interventional pain procedures
Rehabilitation and therapy services
Evaluation & Management services
Identify and mitigate revenue leakage, under-coding, over coding, and duplicate billing risks
Oversee coding compliance, therapy documentation, including:
Plan of care requirements
Timed vs. untimed code rules
Functional outcome reporting
Medical necessity standards
Serve as the escalation point for complex coding determinations and documentation deficiencies
Own enterprise-wide NCCI and CCI edit governance, including:
Edit monitoring and updates
Appropriate modifier application
Edit override review and approval
Collaborate with billing, coding, and IT teams to ensure accurate system configuration and preventive edit controls
Analyze edit-driven denials and implement root cause corrections
Develop and maintain revenue integrity dashboards, including:
Charge error rates
Documentation compliance trends
Audit exposure metrics
NCCI/CCI denial trends
Present findings and risk mitigation strategies to RCM leadership and executive stakeholders
Proactively identify high-risk service lines, providers, and states
Assumes other responsibilities as appropriate to the position and organizational needs
Qualification
Required
Bachelor's degree in healthcare administration, business, or related field (master's preferred)
7+ years progressive experience in Revenue Integrity
7+ years progressive experience in Coding Compliance
7+ years progressive experience in Audit Management
Direct experience in Pain Management and Rehabilitation billing, with a strong Workers' Compensation focus
Strong regulatory and payer knowledge
Ability to translate compliance requirements into operational work flows in pain management, workers comp , or procedural-based specialties
Excellent analytical, communication, and leadership skills
Preferred
CPC, CCS, or CCS-P required
CRC (Certified Revenue Cycle Professional) or CHC (Certified in Healthcare Compliance) Preferred
Benefits
Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
401(K) Plan with Employer Matching
License & Tuition Reimbursements
Paid Time Off
Holiday Pay & Floating Holiday
Employee Perks and Discount Programs
Company
Boomerang Healthcare
We are dedicated to restoring your hope and helping you return to better health with our unique individual treatment plans.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Annu Navani, MD, ABIPP, DABRM, FAARM
Chief Medical Officer
Mike Patel
Chief Information Officer
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