The Revenue Integrity Supervisor oversees the daily operations of the Revenue Integrity department and is responsible for ensuring organizational compliance, accurate charge capture, reimbursement optimization, denial prevention, and revenue preservation initiatives. The Supervisor manages staff, establishes departmental goals, drives performance improvement initiatives, and collaborates across the organization to improve financial outcomes.
Essential Duties and Responsibilities
- Supervise Revenue Integrity Specialists and Team Leads.
- Establish departmental priorities, goals, and performance metrics.
- Conduct hiring, onboarding, training, coaching, and performance evaluations.
- Develop staffing plans and workload distribution strategies.
- Ensure employee productivity and quality benchmarks are achieved.
Financial Performance Oversight
- Lead revenue optimization initiatives throughout the organization.
- Monitor key indicators including:
- Net collection rate
- Denial rate
- Charge lag
- Revenue leakage
- Underpayment recoveries
- Clean claim performance
- Develop action plans to improve reimbursement and reduce financial risk.
Revenue Integrity Program Management
- Oversee:
- Charge capture audits
- Revenue leakage reviews
- Billing compliance assessments
- Coding validation programs
- Pre-bill and post-bill audits
- Ensure consistent execution of revenue integrity processes.
Compliance and Regulatory Oversight
- Maintain compliance with:
- CMS regulations
- OIG guidance
- Federal and state billing regulations
- Commercial payer requirements
- Partner with Compliance on audit findings and corrective action plans.
- Monitor regulatory changes and operational impacts.
Strategic Reporting & Analytics
- Prepare executive-level reporting and presentations.
- Analyze organizational trends and recommend strategic improvements.
- Develop department scorecards and KPI dashboards.
- Present findings to executive leadership and physician leadership.
Provider and Operational Partnership
- Collaborate with medical directors and operational leaders to improve documentation and charging practices.
- Lead educational initiatives supporting providers and departments.
- Participate in provider onboarding and revenue cycle education programs.
- Serve as a key stakeholder in EHR optimization and workflow redesign projects.
Process Improvement
- Lead Lean, Six Sigma, or workflow improvement initiatives.
- Implement automation opportunities to improve efficiency.
- Manage revenue integrity projects from planning through implementation.
- Drive standardization across multiple specialties and locations.
Qualifications
Education
- Bachelor's degree required.
- Master's degree in Healthcare Administration, Business Administration, Finance, or related field preferred.
Experience
- 7-10 years of healthcare revenue cycle experience.
- Minimum 3 years of leadership experience.
- Experience within multi-specialty physician groups, ambulatory surgery centers, or hospital systems preferred.
Certifications Preferred
- CPC
- CPMA
- RHIA
- RHIT
- CCS-P
- Lean Six Sigma Green Belt or higher
Knowledge, Skills, and Abilities
- Advanced understanding of physician and facility revenue cycle operations.
- Strong knowledge of charge capture, coding, compliance, reimbursement, and denial management.
- Proven leadership and team development skills.
- Strategic planning and project management expertise.
- Advanced financial and operational analytics capabilities.
- Ability to influence stakeholders at all organizational levels.