Senior Manager - Revenue Integrity (remote)

Primary Responsibilities

• Provide oversight of coding compliance, ensuring alignment with CMS, Optum, and payer-specific requirements.
• Establish and maintain audit frameworks (prospective and retrospective) to monitor coding accuracy and compliance.
• Identify compliance risks, escalate high-risk findings, and collaborate across Revenue Integrity functions to mitigate identified risks.
• Ensure audit methodologies, scoring, and reporting are consistent and defensible.
• Maintain current knowledge of CPT, ICD-10-CM, HCPCS, CMS regulations, and payer policy updates.
• Serve as a resource for coding and compliance interpretation across teams.
• Translate regulatory changes into operational workflows, education, and guidance.
• Lead, mentor, and develop coding, auditing, and/or education staff.
• Promote a culture of accountability, collaboration, and continuous improvement.

Required Qualifications

• Undergraduate degree or equivalent experience.
• Bachelor's degree in healthcare administration, Health Information Management, or related field preferred.
• CPC, CCS, RHIA, or equivalent coding certification.
• 10+ years of experience in coding, auditing, compliance, or revenue integrity.
• Proven experience leading coding compliance, audit, or education programs.
• Leadership experience managing teams and driving performance.
• Experience with coding audits, QA programs, and compliance monitoring.
• Leadership experience.
• Demonstrated expertise in professional fee coding across multiple specialties.
• Deep knowledge of CPT®, ICD-10-CM, HCPCS, CMS, and payer guidelines.
• Solid understanding of revenue cycle operations, including charge capture and denial management.
• Demonstrated ability to analyze data, identify trends, and translate findings into actionable improvements.
• Proven excellent written and verbal communication skills.

Pay

The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.