Business Operations Director for Financial Performance

We are seeking a highly skilled Revenue Integrity Manager to lead and oversee the daily operations of our Revenue Cycle Department. This position is responsible for driving compliance, optimizing revenue cycle processes, and ensuring accurate and efficient charge capture and reimbursement practices.

The ideal candidate will bring strong leadership skills and a deep understanding of healthcare revenue cycle management. In this role, you will set the tone for departmental culture, foster collaboration, and guide your team to meet organizational goals related to financial performance, compliance, and operational excellence.

Key Responsibilities :

• Provide strategic oversight and daily management of the Revenue Integrity team.
• Lead initiatives to ensure accurate coding, charge capture, and billing practices.
• Monitor and improve processes related to reimbursement, denials management, coverage determinations, and audit compliance.
• Collaborate with case management, billing, coding, and finance departments to support revenue integrity goals.
• Utilize data and reporting tools to identify trends, monitor KPIs, and drive performance improvements.

Required Qualifications :

• Bachelor's degree in a related field (Nursing preferred).
• Minimum of 3 years of experience in HB revenue cycle management, including areas such as reimbursement, coding, denials management, case management, billing / accounts receivable, and auditing.
• At least 2 years of experience in a supervisory or leadership role within healthcare revenue operations.

Preferred Qualifications :

• Coding Certification (CPC, CCS, CPMA, or CRCR).
• Demonstrated leadership and team management experience.
• Proficiency in problem-solving, decision-making, and strategic planning.
• Strong knowledge of Medicare, Medicaid, and third-party payer billing regulations, including Medicare OPPS reimbursement and coverage determinations.