Revenue Integrity Manager - State Program Administrator, Manager Senior

$90,230 - $129,813/Yr

State of Minnesota - Stillwater, MN

Full-time - Manager

Stillwater, MN

Executive, Legislative, and Other General Government Support

About the position

The Revenue Integrity Manager at the Department of Human Services is responsible for overseeing the daily operations of the revenue integrity team within the Direct Care and Treatment division. This role focuses on ensuring compliance with billing, coding, and documentation standards set by various regulatory bodies, including the Centers for Medicare and Medicaid Services (CMS) and State Medicaid. The manager will lead quality assurance processes, monitor policy changes, and implement continuous improvement initiatives to enhance revenue cycle management.

Responsibilities

• Manage the daily operations of the DCT revenue integrity team.
• Monitor the requirements of CMS and other payers for policy, procedures, and protocol changes to assure revenue collections are consistent with all rules and regulations.
• Review coding and billing strategies while implementing quality assurance processes.
• Understand charge master set up and manage updates and ongoing charge master maintenance.
• Prepare and participate in internal and external audits.
• Lead revenue integrity continuous improvement initiatives.
• Provide education and training on revenue integrity best practices, compliance requirements, and changes in billing and coding regulations.

Requirements

• Demonstrated leadership experience, including roles such as supervisor, team lead, or project lead.
• Five years of billing, coding, or revenue collection and integrity experience, including medical billing, cash posting, and charge entry.
• Experience reading, interpreting, and understanding statutes, rules, and regulations.
• Experience researching, solving problems, and initiating corrective actions.
• Experience communicating complex accounting, collection, 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).

Benefits

• Telework eligibility
• Training and development opportunities
• Support resources for employees
• Commitment to equity and inclusion