Director - Revenue Integrity

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Director - Revenue Integrity in the United States.

This is a senior leadership opportunity responsible for driving enterprise-wide revenue integrity strategy across a complex healthcare environment. The role ensures accurate, compliant, and optimized revenue capture across inpatient, outpatient, professional, and research services. You will serve as a key connector between clinical departments, finance, compliance, and technology teams to safeguard revenue and strengthen billing and charging processes. This position plays a critical role in preventing revenue leakage while enhancing transparency, regulatory compliance, and operational efficiency. Operating in a highly collaborative and cross-functional setting, you will influence both strategic direction and hands-on operational execution. The role is ideal for a seasoned healthcare revenue cycle leader who thrives in complex, data-driven, and mission-critical environments.

• Lead enterprise Charge Description Master (CDM) governance, ensuring accuracy, compliance, and continuous improvement of all charge structures and fee schedules.
• Oversee revenue integrity operations including charge capture optimization, revenue reconciliation, and resolution of billing and coding discrepancies.
• Collaborate with clinical departments, physicians, compliance, finance, coding, and revenue cycle teams to ensure accurate and complete charge documentation.
• Partner with technology teams (including EHR and Epic stakeholders) to design, test, and optimize charge capture workflows and system integrations.
• Develop and maintain revenue cycle reporting, dashboards, KPIs, and executive-level insights to monitor performance and identify improvement opportunities.
• Ensure timely adoption of regulatory updates including CMS, CPT, HCPCS, and payer-specific requirements across all billing systems.
• Lead audit readiness efforts, vendor management, and external CDM review processes while driving continuous process improvement initiatives.
• Support strategic pricing alignment efforts and contribute to payer contract performance monitoring and optimization.

Requirements:

• Bachelor’s degree in Business Administration, Healthcare Administration, or a related field.
• 7+ years of progressive experience in revenue integrity, healthcare finance, CDM management, or revenue cycle operations.
• Strong expertise in healthcare reimbursement systems, regulatory compliance, and end-to-end revenue cycle processes.
• Proven leadership experience managing teams and driving cross-functional initiatives in complex healthcare environments.
• Deep knowledge of CMS regulations, CPT/HCPCS coding, UB-04 and CMS-1500 billing structures, and charge capture workflows.
• Strong analytical, financial modeling, and problem-solving skills with the ability to interpret complex data.
• Excellent communication and stakeholder management skills with the ability to influence clinical and executive audiences.
• Relevant certifications such as CHRI, CPC, CCS, RHIT, or RHIA required or strongly preferred.
• Ability to manage multiple priorities, drive strategic initiatives, and operate effectively in a highly regulated environment.

Benefits:

• Competitive hourly compensation ranging from approximately $83.98 to $111.27 per hour, depending on experience and qualifications.
• Comprehensive benefits package including medical, dental, vision, disability, and life insurance.
• Retirement savings plans and financial security programs.
• Generous paid time off and paid holidays.
• Professional development opportunities and support for certifications.
• Exposure to enterprise-level healthcare operations and strategic revenue initiatives.
• Inclusive and mission-driven work environment focused on patient-centered care.
• Opportunities to lead high-impact transformation across revenue cycle and financial operations.