What are the responsibilities and job description for the Manager of Revenue Integrity position at Carson Tahoe Health?
US:NV:Carson City
Full Time Standard Office Hours
Summary
The Manager of Revenue Integrity provides strategic and operational leadership to ensure healthcare services are accurately captured, billed, and reimbursed. This role oversees revenue integrity activities including charge capture, Charge Description Master (CDM) management, billing and coding integrity, reimbursement optimization, compliance, and revenue leakage prevention. Working across clinical, operational, financial, coding, compliance, and technology teams, the Manager identifies opportunities, solves complex revenue cycle challenges, strengthens processes, and helps ensure the organization is positioned for accurate and sustainable reimbursement. This is an opportunity for an experienced revenue cycle leader to make a meaningful impact on both financial performance and the quality of the systems and processes behind it.
What You’ll Do
- Lead revenue integrity operations and strategy — Oversee day-to-day revenue integrity activities and develop proactive monitoring strategies to ensure accurate charge capture, compliant billing, appropriate reimbursement, and timely resolution of issues.
- Protect revenue and identify opportunities — Analyze revenue cycle data, audits, denials, workflows, and trends to uncover revenue leakage, reimbursement opportunities, billing issues, and process gaps, then lead corrective actions and prevention strategies.
- Own charge capture and CDM integrity — Oversee Charge Description Master (CDM) governance and maintenance, including new services, CPT/HCPCS mapping, revenue codes, pricing, regulatory updates, and charging workflows.
- Serve as a revenue integrity expert and compliance partner — Provide guidance on billing regulations, coding and charging requirements, reimbursement methodologies, payer requirements, and compliance while partnering with Compliance, HIM, Patient Financial Services, and operational teams to address risk.
- Drive cross-functional improvement and innovation — Partner with clinical, operational, finance, IT, and revenue cycle teams to improve workflows, optimize EMR charging processes, implement system enhancements, and ensure new services and technologies are appropriately integrated into the revenue cycle.
- Lead people, performance, and continuous improvement — Develop and support Revenue Integrity staff while establishing performance metrics, dashboards, policies, education, and process improvement initiatives that strengthen revenue cycle performance and organizational growth.
Qualifications
Required:
- Bachelor’s degree in Health Information Management, Healthcare Administration, Business Administration, Healthcare Management, or related field, or equivalent combination of education and experience.
- Minimum of five (5) years of progressively responsible experience in healthcare revenue cycle, revenue integrity, hospital billing, billing compliance, coding compliance, reimbursement, auditing, charge capture, or related operations.
- Minimum of three (3) years of progressive leadership, supervisory, project leadership, or program oversight experience.
- Demonstrated knowledge of hospital and/or professional billing requirements, reimbursement methodologies, Medicare, Medicaid, commercial payer requirements, and healthcare revenue cycle operations.
- Working knowledge of CPT, HCPCS, ICD-10-CM, revenue codes, billing edits, charge capture, and healthcare billing and coding compliance requirements.
- Experience analyzing complex revenue cycle issues, conducting audits or reviews, identifying root causes, and implementing corrective actions and process improvements.
- Demonstrated ability to collaborate effectively across clinical, operational, financial, compliance, and technical teams.
Preferred:
- Master’s degree in Healthcare Administration, Business Administration, Health Information Management, Finance, or related field.
- Certified Revenue Integrity Professional (CRIP) or other recognized revenue integrity certification.
- Certified Revenue Cycle Representative (CRCR), Certified Healthcare Financial Professional (CHFP), CPC, CCS, CPMA, CHC, RHIA, RHIT, or comparable credential.
- Experience leading or supporting a formal revenue integrity program within a hospital or integrated health system.
- Experience with CDM management, charge capture optimization, billing compliance auditing, revenue leakage prevention, denial prevention, reimbursement optimization, or payer audits.
- Experience in a hospital, multi-specialty physician practice, or integrated health system environment.
- Experience with Epic revenue cycle applications, charging workflows, work queues, reporting tools, and revenue integrity functionality.
Top 5 Reasons to Live in Carson City, Nevada
- Live, work and play in one of the most beautiful regions in the world
- Enjoy an array of outdoor activities world class skiing, golf, camping, mountain biking, hiking, water skiing, kayaking, hunting and fishing
- Just next door is Beautiful Lake Tahoe
- We are minutes from Reno known as the 'biggest little city in the world' - Fine dining, nightlife, shopping and home to the University of Nevada Reno.
- Family friendly atmosphere with affordable housing & excellent school system
Our Benefits
- No State Income Tax
- Medical, Dental, Vision, FSA, Telehealth
- Paid Time Off, Mental Health, and Volunteer Days
- 100% Vested 401K & Roth with Company Contribution
- Tuition Reimbursement
- Referral Bonuses
- On Site Education & Certification Programs
- Base Wage Increases for Relevant Advanced Degrees
- Free Calm App Subscription
About Carson Tahoe Health
CTH is a not-for-profit healthcare system with 240 licensed acute care beds, fully accredited by the Center for Improvement in Healthcare Quality (CIHQ). CTH was voted 5th most beautiful hospital in the nation nestled among the foothills of the Sierra Nevada in North Carson City and only a short drive away from world-famous Lake Tahoe & Reno. We serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations.