Director of Revenue Integrity

GetHired, Inc.; Florida; On-site; USD 150,000 - 190,000; Full time

Job summary

GetHired, Inc. is seeking a Director of Revenue Integrity to maximize revenue capture, ensure accurate coding, and optimize reimbursements across a growing Florida multi-specialty platform.

The role bridges clinical operations, RCM, compliance, finance, and IT, leading charge capture, denial management, analytics, and performance improvement across physician practices, infusion centers, and ancillary services.

Qualifications

• 7+ years of progressive healthcare revenue cycle experience.
• 3+ years of leadership experience in revenue integrity, revenue cycle, coding, compliance, or healthcare finance.
• Deep understanding of physician practice revenue cycle operations.
• Experience with Medicare, Medicaid, and commercial payer reimbursement.
• Strong analytical and financial modeling skills.
• Experience developing KPI dashboards and executive reporting.

Responsibilities

• Develop and implement a comprehensive revenue integrity program across all specialties and service lines.
• Identify, quantify, and remediate sources of revenue leakage.
• Establish processes to ensure accurate charge capture and reimbursement.
• Monitor trends impacting collections, net revenue, denials, and write-offs.
• Develop revenue enhancement initiatives in partnership with operations and finance leadership.
• Evaluate payer reimbursement performance and identify opportunities for improvement.
• Oversee coding compliance and documentation improvement initiatives.
• Coordinate provider coding audits and educational programs.
• Partner with providers and clinical leadership to improve documentation quality and accuracy.
• Analyze denial trends and root causes.
• Develop denial prevention strategies and KPI reporting.
• Develop executive-level dashboards and performance metrics.
• Collaborate with patient access leadership on scheduling, referrals, authorizations, insurance verification, and financial clearance workflows.
• Support payer negotiations through reimbursement modeling and data analytics.

Skills

Analytical skills

Financial modeling

Leadership

Education

Bachelor’s degree in healthcare administration, business, finance or accounting

Tools

eClinicalWorks

Job description

About the job

About Central Florida Health Care Services & Central Florida Rheumatology Consultants

Central Florida Health Care Services (CFHCS) and Central Florida Rheumatology Consultants (CFRC) are rapidly growing healthcare organizations focused on expanding access to specialty care, infusion services, pharmacy services, and integrated healthcare delivery across Florida.

Today, the organization operates one of the largest rheumatology and infusion platforms in Central Florida and is actively expanding through physician recruitment, acquisitions, de novo locations, pharmacy integration, technology enablement, and operational innovation. Over the next several years, the organization expects significant growth across rheumatology, infusion, specialty pharmacy, primary care, and ancillary service lines throughout Central Florida, Tampa Bay, and South Florida.

As part of this growth strategy, we are building scalable infrastructure, best-in-class operational capabilities, and data-driven performance management systems that will support long-term expansion while maintaining exceptional patient care and clinical outcomes.

The Director of Revenue Integrity will play a critical leadership role in ensuring the organization captures, protects, and optimizes revenue across all service lines as we continue to scale.

Position Summary

The Director of Revenue Integrity is responsible for maximizing revenue capture, ensuring billing and coding accuracy, improving reimbursement performance, and reducing revenue leakage across a growing multi-specialty healthcare organization. This leader serves as the bridge between clinical operations, revenue cycle management, patient access, coding, compliance, finance, and information technology to ensure services are accurately documented, coded, billed, and reimbursed.

The Director of Revenue Integrity will lead initiatives focused on charge capture, coding compliance, denials prevention, payer reimbursement optimization, provider education, revenue analytics, workflow redesign, and operational performance improvement. This individual will play a key role in supporting organizational growth, operational scalability, and financial performance across physician practices, infusion centers, pharmacy operations, and ancillary service lines.

Revenue Integrity & Revenue Optimization

• Develop and implement a comprehensive revenue integrity program across all specialties and service lines.
• Identify, quantify, and remediate sources of revenue leakage.
• Establish processes to ensure accurate charge capture and reimbursement.
• Monitor trends impacting collections, net revenue, denials, and write-offs.
• Develop revenue enhancement initiatives in partnership with operations and finance leadership.
• Evaluate payer reimbursement performance and identify opportunities for improvement.

Coding & Clinical Documentation

• Oversee coding compliance and documentation improvement initiatives.
• Coordinate provider coding audits and educational programs.
• Analyze coding patterns, utilization trends, and reimbursement impacts.
• Ensure compliance with CMS, Medicare, Medicaid, and commercial payer requirements.
• Partner with providers and clinical leadership to improve documentation quality and accuracy.

Denials Management

• Analyze denial trends and root causes.
• Develop denial prevention strategies.
• Monitor payer behavior and reimbursement changes.
• Partner with RCM teams to improve first-pass claim acceptance and reduce avoidable denials.
• Establish denial KPIs and performance reporting.

Revenue Analytics & Reporting

• Develop executive-level dashboards and performance metrics.
• Analyze revenue by provider, specialty, diagnosis, location, payer, and service line.
• Monitor productivity, reimbursement, collections, and revenue cycle performance.
• Present findings and recommendations to executive leadership.
• Support budgeting, forecasting, and strategic planning activities.

Patient Access & Front-End Revenue Cycle

• Collaborate with patient access leadership on scheduling, referrals, authorizations, insurance verification, and financial clearance workflows.
• Lead the organization’s Revenue Integrity function within the Mini Central Business Office structure.
• Identify opportunities to improve patient access while reducing downstream denials.
• Support centralized scheduling, referral management, authorization, and financial clearance initiatives.

Payer Strategy & Contracting Support

• Analyze reimbursement trends and contract performance.
• Support payer negotiations through reimbursement modeling and data analytics.
• Identify underperforming contracts and reimbursement opportunities.
• Monitor fee schedule changes and regulatory updates.
• Assist leadership in developing payer optimization strategies.

Technology & Process Improvement

• Partner with IT and operational leaders to optimize revenue cycle technologies.
• Improve utilization of eClinicalWorks and related reporting tools.

• Lead workflow redesign initiatives focused on revenue capture and operational efficiency.
• Evaluate automation, AI, and technology solutions that improve revenue cycle performance.

Qualifications Required

• Bachelor’s degree in Healthcare Administration, Business, Finance, Accounting, or related field.
• 7+ years of progressive healthcare revenue cycle experience.
• 3+ years of leadership experience in revenue integrity, revenue cycle, coding, compliance, or healthcare finance.
• Deep understanding of physician practice revenue cycle operations.
• Experience with Medicare, Medicaid, and commercial payer reimbursement.
• Strong analytical and financial modeling skills.
• Experience developing KPI dashboards and executive reporting.

Preferred

• Multi-specialty physician practice experience.
• Experience in rheumatology, infusion services, specialty pharmacy, oncology, gastroenterology, cardiology, orthopedics, or other specialty physician groups.
• CPC, CPMA, CHRI, CRCR, RHIA, RHIT, or similar certification.
• Experience with eClinicalWorks or similar EHR/PM systems.
• Experience supporting payer negotiations and reimbursement strategy.
• Experience in a high-growth, private equity-backed, or acquisitive healthcare environment.

Success Metrics

The Director of Revenue Integrity will be measured on:

• Net collection rate improvement.
• Reduction in revenue leakage.
• Coding accuracy and compliance performance.
• Reduction in denial rates.

• Improvement in clean claim rates.

• Improvement in charge capture accuracy.
• Provider documentation improvement.
• Payer reimbursement optimization.
• Revenue cycle KPI performance.
• Successful implementation of revenue integrity initiatives across new locations and acquisitions.
• Development of scalable revenue integrity infrastructure.

Why Join Us

This is a unique opportunity to build and lead a revenue integrity function within one of Florida’s fastest-growing specialty healthcare platforms. The successful candidate will work directly with executive leadership and clinical leaders to develop scalable systems, improve financial performance, support acquisitions and growth initiatives, and help build a best-in-class healthcare organization serving patients across Florida.