Revenue Integrity Supervisor - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ

Position Overview

The Revenue Integrity Lead oversees daily operations of Revenue Integrity work queues and staff, ensuring accurate, compliant, and timely pre-bill claim readiness across hospital and ambulatory services.

Minimum Requirements

• Education: Associate degree in Nursing, Health Information, Healthcare Administration, Business, or related field required. Bachelor’s degree preferred.
• Experience: Four years' progressively responsible experience in hospital revenue cycle, revenue integrity, patient financial services, or related function required. One year' lead/supervisory experience preferred.
• Demonstrated experience with pre-bill charge review, authorization workflows, and account-level correction processes required. Experience with procedural areas (OR, Cath Lab, IR, imaging, cardiology, etc.) preferred.

Other Credentials

• Strong knowledge of hospital charge capture, CPT/HCPCS/revenue code usage, and claim workflow dependencies.
• Strong understanding of payer authorization requirements and procedure/auth alignment risks.
• Strong analytical, organizational, and follow-through skills with the ability to manage high-volume, time-sensitive work queues.
• Strong communication and conflict-resolution skills across clinical, operational, and physician office stakeholders.
• Ability to coach staff, enforce standards, and drive accountability.

Special Training

• Proficiency in EHR and revenue cycle systems, work queues, and account review tools.
• Strong Excel and reporting/dashboard proficiency.
• Ability to document trends, root causes, and corrective action plans.

Mental, Behavioral and Emotional Abilities

• Ability to function with minimal supervision and exercise sound judgment.
• Ability to collect, create and research complex or diverse information.

Essential Functions

• Supervises day-to-day Revenue Integrity operations and staff performance across assigned work queues.
• Assigns, prioritizes, and monitors work based on risk, filing timeliness, and financial exposure.
• Oversees pre-bill charge integrity review, including missing/incorrect CPT, HCPCS, revenue code, and unit corrections.
• Oversees authorization integrity workflows including: pre-service verification that required authorizations are present and accurate, and post-procedure pre-bill validation that approved authorization(s) match procedures actually performed (CPTs, units, setting, dates, site of service).
• Oversees surgical/procedural revenue integrity controls, including implant/drug/device reconciliation, invoice availability checks, and hold/release management for unresolved high-risk accounts.
• Captures daily escalation management with Central Scheduling, procedural departments, physician offices, pharmacy, and billing to resolve issues before claim finalization.
• Enforces standard documentation requirements for account notes, issue categorization, action tracking, and closure rationale.
• Performs quality audits of teamwork, provides feedback, and drives corrective action for performance and process variation.
• Partners with CDM resources to route and prioritize recurring build/maintenance defects identified through account-level review.
• Supports implementation of policy changes, payer rule updates, and workflow redesign under direction of the Manager, Revenue Integrity.
• Maintains cross-functional working relationships and participates in recurring operational huddles and governance meetings.
• Coaches team members, supports onboarding/training, and builds bench strength for role continuity and succession.
• Performs other duties as assigned.

Physical Demands and Work Environment

• Frequent Physical Demands Include: Standing, Walking, Climbing (e.g., stairs or ladders), Carry objects, Push/Pull, Twisting, Bending, Reaching forward, Reaching overhead, Squat/kneel/crawl.
• Continuous Physical Demands Include: Sitting, Wrist position deviation, Pinching/fine motor activities, Keyboard use/repetitive motion, Talk or Hear.

Usual Work Day

• 8 Hours

Reporting Relationships

Does this position formally supervise employees? Yes

PHYSICAL DEMANDS AND WORK ENVIRONMENT

• Frequent Physical Demands Include: Standing, Walking, Climbing (e.g., stairs or ladders), Carry objects, Push/Pull, Twisting, Bending, Reaching forward, Reaching overhead, Squat/kneel/crawl.
• Continuous Physical Demands Include: Sitting, Wrist position deviation, Pinching/fine motor activities, Keyboard use/repetitive motion, Talk or Hear.

Usual Work Day

• 8 Hours

Reporting Relationships

Does this position formally supervise employees? Yes

Benefits

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA)
• Healthcare FSA
• Dependent Care FSA
• Retail Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits – Long Term Disability (LTD)
• Disability Benefits – Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance
• Voluntary Life Spouse
• Voluntary Life Employee
• Child
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance
• Voluntary Pet Insurance
• Paid Time-Off Program