Revenue Integrity Manager - State Program Administrator, Manager Senior

$90,230 - $129,813/Yr

State of Minnesota - Marshall, MN

Full-time - Mid Level

Marshall, MN

Executive, Legislative, and Other General Government Support

About the position

The Revenue Integrity Manager is responsible for overseeing the daily operations of the Direct Care and Treatment (DCT) revenue integrity team within the Department of Human Services. This role focuses on ensuring compliance with billing, coding, and documentation standards set by the Centers for Medicare and Medicaid Services (CMS), State Medicaid, and other third-party payers. The manager will lead quality assurance processes, monitor policy changes, and provide education on revenue integrity best practices.

Responsibilities

• Managing the daily operations of the DCT revenue integrity team.
• Monitoring the requirements of CMS and other payers for policy, procedures, and protocol changes.
• Reviewing coding and billing strategies while implementing quality assurance processes.
• Understanding charge master setup and managing updates and ongoing charge master maintenance.
• Preparing and participating in internal and external audits.
• Leading revenue integrity continuous improvement initiatives.
• Providing education and training on revenue integrity best practices, compliance requirements, and changes in billing and coding regulations.

Requirements

• Demonstrated leadership experience, including supervisory or team lead roles.
• Five years of billing, coding, or revenue collection and integrity experience.
• Experience with medical billing, cash posting, and charge entry.
• Ability to read, interpret, and understand statutes, rules, and regulations.
• Experience in researching, solving problems, and initiating corrective actions.
• Strong communication skills for conveying complex accounting and compliance concepts.

Nice-to-haves

• Bachelor's degree in business administration, healthcare administration, finance, or related field.
• Knowledge of ICD-10-CM, CPT/HCPCs procedure coding.
• Knowledge of hospital revenue cycle operations.
• Training as a Certified Revenue Cycle Professional (CPCR), Certified Healthcare Financial Professional (CHFP), or Certified Payment and Reimbursement (CSPR).
• Experience working effectively with diverse backgrounds and cultures.