Revenue Integrity & Coding Manager

Horizon Health; Paris (IL); On-site; USD 70,000 - 112,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) plan

Paid time off

Job summary

Horizon Health in Paris, IL is seeking a Manager of Coding & Revenue Integrity to oversee coding operations across hospital and professional settings, drive accuracy, and ensure regulatory compliance. You will partner with Finance and Revenue Cycle leadership to optimize reimbursements and reduce denials.

The role requires leadership experience, RHIT/RHIA or CCS/CPC certifications, and a strong working knowledge of CDM, CPT/HCPCS, and payer guidelines.

Qualifications

• 5+ years of hospital and/or professional coding experience.
• Leadership experience of 2–3 years preferred.
• Experience with diverse reimbursement methodologies (CAH, RHC, EMS) is a plus.

Responsibilities

• Oversee coding operations across HB & PB settings.
• Monitor accuracy, productivity, and turnaround times; drive improvements.
• Oversee charge capture and CDM governance; ensure regulatory compliance.

Skills

Hospital coding

Revenue integrity

Charge capture

Leadership

Regulatory compliance

Education

RHIT

RHIA

CCS

CPC

Tools

EHR systems

Encoder software

Billing systems

Job description

Horizon Healthis a Critical Access, Rural Health Facility comprised of 25-inpatient beds located in Paris, IL & a multitude of outpatient clinic settings including Family Practice and Specialty Clinics in Paris and surrounding cities. We have been serving residents of Edgar County since 1968 though community education, emergency services, and outpatient care. As we continue to expand our services & locations, our community has grown far beyond Paris. Our rich history and strong community support pave the way for the future of healthcare as we serve you—our family, friends, and neighbors.

Position Summary:

The Manager of Coding & Revenue Integrity is responsible for the performance, accuracy, compliance, and accountability of hospital and professional coding, charge capture processes, and chargemaster (CDM) governance across the organization. Responsibilities span all organizational service lines and reimbursement methodologies, including Critical Access Hospital (CAH), Rural Health Clinic (RHC), Emergency Medical Services (EMS), hospital-based (HB), professional-based (PB), and other provider-based services, as applicable.

This role ensures accurate and timely code assignment, complete and compliant charge capture, and effective CDM governance to support accurate reimbursement, reduce denials, and prevent revenue leakage while maintaining compliance with federal, state, payer, and organizational requirements. Working in a Critical Access Hospital environment, the Manager balances coding and revenue integrity operations with financial performance and regulatory compliance across Horizon's diverse reimbursement methodologies.

The Manager partners closely with clinical departments, Patient Access, Central Business Office, Finance, providers, and Revenue Cycle leadership to improve documentation, coding accuracy, charge capture, and reimbursement outcomes. The Manager is accountable for department performance, workflow standardization, staff effectiveness, audit readiness, and continuous improvement across Coding & Revenue Integrity operations.

Essential Functions (Responsibilities/Accountabilities):

Coding, Revenue Integrity & Reimbursement

• Lead enterprise hospital and professional coding and revenue integrity operations across applicable service lines and reimbursement methodologies.
• Ensure coding and charge capture are accurate, complete, timely, and compliant with payer, regulatory, and organizational requirements.
• Oversee coding and reimbursement processes supporting Medicare, Medicaid, managed care, commercial payers, and specialized methodologies, including CAH, RHC, EMS, HB, PB, and other provider-based services.
• Identify and address barriers to coding completion, charge capture, reimbursement, and revenue integrity performance.

Chargemaster & Charge Capture Governance

• Oversee CDM governance and maintenance, including CPT/HCPCS, revenue code, pricing alignment, annual updates, and regulatory changes.
• Partner with clinical and operational departments to strengthen documentation and charge capture processes and resolve missing, inaccurate, or unsupported charges.

Denials, Auditing & Compliance

• Analyze coding- and charge-related denials, audits, and compliance risks; identify root causes and implement or escalate corrective actions.
• Coordinate internal and external coding and charge capture audits, education, and corrective action plans to support sustained compliance and reimbursement accuracy.

Operational Performance & Improvement

• Establish, monitor, and manage department performance against organizational and revenue cycle goals; use operational and financial data to identify trends, address performance gaps, and drive sustained improvement.
• Standardize and continuously improve coding, documentation, charge capture, and revenue integrity policies, procedures, workflows, and work queues.
• Monitor regulatory, coding, and payer changes and ensure timely implementation of required operational updates.
• Maintain operational and audit readiness and support organizational compliance and revenue cycle improvement initiatives.
• Recruit, develop, coach, and manage Coding & Revenue Integrity staff; establish clear expectations and accountability for quality, productivity, compliance, service, and performance.
• Partner with Revenue Cycle leadership, providers, clinical departments, Patient Access, Central Business Office, Finance, and other stakeholders to strengthen end-to-end revenue cycle performance.

The responsibilities listed above are not all-inclusive; other activities may be required in support of the hospital's goals and objectives.

Position Requirements:

Education & Experience

• Associate's degree required; bachelor's degree in Health Information Management, Healthcare Administration, or related field preferred.
• Five (5)+ years of progressive experience in hospital and/or professional coding, revenue integrity, or charge capture, including 2-3 years of leadership or supervisory experience.
• Experience supporting hospital and professional coding and multiple healthcare service lines or reimbursement methodologies preferred; CAH, RHC, EMS, and/or rural healthcare experience strongly preferred.
• Demonstrated success improving coding accuracy, reducing denials, strengthening charge capture, or improving related revenue cycle performance.
• Relevant coding certification required (e.g., RHIT, RHIA, CCS, CPC).

Required Knowledge & Skills

• Comprehensive knowledge of ICD-10-CM/PCS, CPT, HCPCS, NCCI edits, medical necessity requirements, LCD/NCD guidance, and applicable coding and reimbursement regulations.
• Working knowledge of Medicare, Medicaid, managed care, and commercial payer requirements and the reimbursement methodologies applicable to CAH, RHC, EMS, HB, PB, and other provider-based services.
• Strong understanding of revenue integrity principles, including charge capture, documentation alignment, CDM structure and maintenance, audit processes, and compliance requirements.
• Experience with EHR systems, coding/encoder tools, billing systems, reporting tools, dashboards, and data analysis; ability to use performance data to identify risks and improvement opportunities.
• Demonstrated ability to lead, develop, and hold coding and revenue integrity teams accountable for quality, productivity, compliance, and performance.
• Strong analytical, problem-solving, communication, education, and cross-functional collaboration skills.
• Ability to standardize workflows, manage competing priorities, lead change, and drive continuous performance improvement.
• High degree of professionalism, integrity, accuracy, accountability, and attention to detail.

Pay Range:

Pay ranges from $69,903k to $111,844k (rate of pay is based on applicable years of experience)

Horizon Health is committed to caring not only for our patients, but for our staff as well. We offer you an extensive total compensation and benefits package. As an employee of Horizon Health, your benefits include a competitive salary, medical, dental and vision insurance, Employee 403(b), health savings account with Company match, as well as Vacation, Sick and Paid Holidays.

Intrigued? Don’t wait, apply today. We are actively reviewing applicants for the Coding and Revenue Integrity Manager. Be part of an organization that is dedicated to the growth and development of its colleagues. Here at Horizon Health, our employees speak for themselves. Join our family & begin an incredible career!