Manager, Revenue Integrity

WakeMed

Raleigh, North Carolina, United States

Raleigh, North Carolina, United States

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Overview Provides strategic leadership and technical oversight for the Revenue Integrity Department. Ensures accurate, complete, timely charge capture and reconciliation, optimizes reimbursement, safeguards compliance with regulatory standards. Leads operational initiatives across nurse auditing, coding, Charge Description Master (CDM) maintenance, denial management, collaborating with clinical, financial, and operational teams. Through innovative strategies and continuous process improvement, this position enhances revenue cycle performance and supports organizational financial health.
Leadership and Oversight: Supervise and mentor the Revenue Integrity teams (nurse auditors, coders, analysts, specialists). Monitor performance metrics, implement continuous improvement, conduct performance evaluations, and support professional development.
Charge Capture and Systems Management: Oversee the development and execution of revenue integrity initiatives; manage EHR Revenue Cycle systems and billing platforms; direct and support CDM maintenance and analytics; collaborate on pricing oversight; research, evaluate, and interpret regulatory and payor guidance; monitor and evaluate billing and coding updates.
Compliance and Audit: Ensure federal, state, and payor regulations; lead internal audits and process reviews; identify revenue leakage and compliance risks; collaborate with stakeholders.
Revenue Optimization: Develop and manage denial prevention and resolution strategies; provide analytics and KPIs to executive leadership; drive alignment with financial objectives and identify improvement opportunities.
Stakeholder Collaboration: Engage clinical and ancillary leadership; monitor KPIs, implement process improvements, manage denial and audit risks, deliver education; serve as liaison for denials and avoidable write‑off committee.
Policy and Documentation: Develop operational policies, procedures, and training documentation; promote a patient‑centric culture.
Community Engagement: Represent the department at community and agency events.
Location Eligible remote states include NC, FL, GA, SC, SD, TN, TX and VA.
Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well‑being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org.
Equal Opportunity Employment EOE
Licensure
Certified Professional Coder (Preferred)
Registered Health Information Administrator (Preferred)
Certified Coding Specialist (Preferred)
Registered Health Information Technician (Preferred)
Project Management Professional (Preferred)
Education Bachelor's Degree in Healthcare, Accounting, or Finance (Required)
Experience
3 Years Leadership (Required)
1 Year Project Management (Required)
5 Years Healthcare (Required)
7 Years Health Information Management (Preferred)
7 Years Accounting/Finance – Revenue Cycle (Preferred)
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Raleigh, North Carolina, United States

Sprachkenntnisse

English

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