Revenue Integrity Manager

JOB REQUIREMENTS: Back Revenue Integrity Manager #25-417 Green Bay,Wisconsin, United States Apply X Facebook LinkedIn Email Copy LocationHansen-006 Description Revenue Integrity Manager Come work where wespecialize in you We have nearly 2,000 reasons for you to consider acareer with Prevea Health-they're our employees. We're an organizationthat values kindness, responsibility, inclusivity, wellness andinspiration. At Prevea, we provide continuous education, training andsupport so every member of the team contributes to our success. Togetherwe are the best place to get care and the best place to give care. JobSummary The Revenue Integrity Manager will lead the development of therevenue integrity function and is responsible for the oversight andmanagement of the revenue integrity team. This position is accountablefor optimizing revenue by ensuring accurate, compliant, and efficientcharge capture and billing practice. The Revenue Integrity Manager willimprove the performance of revenue cycle processes including developingbest practices, coordinating issue resolution, establishing proactivelost revenue prevention measures, and monitoring compliance. The idealcandidate has a strong understanding of EPIC systems, coding standards,and billing regulations across both physician and facility revenuestreams. What you will do Utilize data analytics and process improvementtechniques to identify potential revenue leakage and support accuratecharge capture. Use EPIC reporting tools to extract and analyze chargedata. Perform extensive data mining, develop reports, review trends, andrecommend enhancements to resolve lost revenue. Manage a team of chartreviewers. Design and implement a chart review program to ensurecompleteness of records, appropriateness of billing, and compliance withregulatory and payer requirements. Identify coding and documentationdiscrepancies to provide recommendations. Monitor for positive ornegative trends in coding, charge capture and/or editing processes.Analyze denial trends related to charge capture and billing. Collaboratewith coding, billing, and clinical teams to identify root causes andimplement corrective actions. Maintain documentation of audit findings,trends, and resolutions to support compliance and training efforts.Measure key performance indicators (KPIs). Prepare reports and presentfindings and recommendations to management. Oversee and maintain theCDM, identifying opportunities for missed revenue. Including an annualcomparison of Prevea's CDM and supply/implant costs to payer contracts.Develop and maintain all retail pricing. Participate in service linepricing reviews. Research and stay current on CMS, federal and stateregulations, payor guidelines, ensuring compliance and alignment withcharge, coding and charge edits. Complete... For full info followapplication link. Prevea is an Equal Employment Opportunity/AffirmativeAction employer APPLICATION INSTRUCTIONS: Apply Online:ipc.us/t/9CB695E6AA8A43B1

Created: 2025-12-22