Remote Director, Revenue Integrity & Denials Management

Cape Cod Healthcare Inc

Hyannis (MA)

On-site

USD 145,000 - 180,000

Full time

6 days ago

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Job summary

Cape Cod Healthcare Inc. seeks a Director of System Revenue Integrity to develop and execute the strategic vision for system-wide revenue integrity across hospital, professional, and ancillary services. You will lead KPI programs, drive policy and process improvements, and oversee charge review, denial management, and audit outcomes at the system level.

REMOTE CANDIDATES CONSIDERED. The role reports to the Revenue Cycle leadership and collaborates with HR, IT, and Finance.

Qualifications

Bachelor's degree in Business Administration or related field.
5–7 years in a complex healthcare revenue cycle.
3–5 years of supervisory/management experience.
Strong knowledge of billing, collection, charging processes and revenue integrity.
Strong analytics and data synthesis to forecast trends and improve processes.

Responsibilities

Lead KPI development for revenue integrity and audit functions; implement action plans where needed.
Develop and oversee policies, processes, tools, and training across Revenue Integrity.
Oversee system-wide Charge Review to minimize revenue leakage and improve charge capture.
Ensure CDM compliance with regulatory and payer requirements and established methodologies.
Manage revenue integrity policies, processes, and quality assurance programs across functions.
Monitor SLAs and ensure effective communication with Revenue Cycle and Clinical operations.