Revenue Integrity Manager - 259025

Medix™; New York (NY); On-site; USD 110,000 - 170,000; Full time

Job summary

Medix is seeking a Revenue Integrity Manager to optimize the revenue cycle for our growing ABA therapy organization. This hands‑on role partners across Revenue Cycle, Billing, Finance, and Clinical Operations to prevent revenue leakage, improve reimbursement, and strengthen overall billing performance.

You will build and coach a team, improve processes, and own revenue integrity initiatives across multiple locations and payors.

Qualifications

• 5+ years of healthcare billing/RCM experience.
• 2+ years of ABA or behavioral health billing experience.
• Hands-on experience with CentralReach or another ABA practice management system.
• Strong knowledge of commercial and Medicaid reimbursement, authorizations, CPT coding, and payor policies.
• Experience with denials, underpayments, claim rejections, charge capture, and revenue cycle analytics.

Responsibilities

• Lead revenue integrity functions including denials prevention, underpayments, overpayments, payment posting, cash reconciliation, and charge master maintenance.
• Analyze denial and rejection trends to identify root causes and implement denial prevention initiatives.
• Manage clearinghouse work queues, payor rules, enrollments, and claim rejections to improve first-pass claim rates.
• Maintain CentralReach charge capture, fee schedules, and billing rules to support accurate reimbursement.
• Review reimbursement reports to identify underpayments and payor discrepancies.
• Oversee medical record requests, payor audits, recoupments, refunds, and compliance-related processes.
• Partner with Billing, Authorizations, Clinical, and Finance teams to identify and eliminate revenue leakage.
• Track key RCM metrics including Days in A/R, denial rates, unbilled A/R, clean claim rate, and net realization.
• Build, coach, and mentor a team of Revenue Integrity professionals.

Skills

Revenue integrity

Denials prevention

Billing analytics

Excel (Pivot tables)

Team leadership

Education

Bachelor's degree in Healthcare Administration, Finance, Business, or related field

Tools

CentralReach

Job description

Monday–Friday | Standard Business Hours

About the Opportunity

We’re looking for a Revenue Integrity Manager to help optimize the revenue cycle for a growing ABA therapy organization. This is a highly visible role partnering across Revenue Cycle, Billing, Finance, and Clinical Operations to prevent revenue leakage, improve reimbursement, reduce denials, and strengthen overall billing performance.

You’ll have the opportunity to build and coach a team, improve processes, and take ownership of revenue integrity initiatives across multiple locations and payors.

What You’ll Own

• Lead revenue integrity functions including denials prevention, underpayments, overpayments, payment posting, cash reconciliation, and charge master maintenance
• Analyze denial and rejection trends to identify root causes and implement denial prevention initiatives
• Manage clearinghouse work queues, payor rules, enrollments, and claim rejections to improve first-pass claim rates
• Maintain CentralReach charge capture, fee schedules, and billing rules to support accurate reimbursement
• Review reimbursement reports to identify underpayments and payor discrepancies
• Oversee medical record requests, payor audits, recoupments, refunds, and compliance-related processes
• Partner with Billing, Authorizations, Clinical, and Finance teams to identify and eliminate revenue leakage
• Track key RCM metrics including Days in A/R, denial rates, unbilled A/R, clean claim rate, and net realization
• Build, coach, and mentor a team of Revenue Integrity professionals

What We’re Looking For

• 5+ years of healthcare billing/RCM experience, with strong revenue integrity experience
• 2+ years of ABA or behavioral health billing experience
• Hands-on experience with CentralReach or another ABA practice management system
• Strong knowledge of commercial and Medicaid reimbursement, authorizations, CPT coding, and payor policies
• Experience with denials, underpayments, claim rejections, charge capture, and revenue cycle analytics
• Strong Excel skills, including pivot tables, VLOOKUP/XLOOKUP, and data analysis
• Bachelor’s degree in Healthcare Administration, Finance, Business, or related field preferred
• Previous team leadership or supervisory experience preferred
• CRCR, CHRI, CPC, CPMA, or similar certification is a plus

Why Consider This Role?

This is an opportunity to step into a hands‑on Revenue Integrity leadership position where you can directly influence reimbursement, improve processes, develop a team, and partner with clinical and financial leadership.