Revenue Integrity Manager - State Program Administrator, Manager Senior

$90,230 - $129,813/Yr

State of Minnesota - Anoka, MN

Full-time - Mid Level

Anoka, MN

Executive, Legislative, and Other General Government Support

About the position

The Revenue Integrity Manager at the State of Minnesota is responsible for overseeing the daily operations of the Direct Care and Treatment (DCT) revenue integrity team. This role ensures 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 implement continuous improvement initiatives within the revenue cycle management team.

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 to assure revenue collections are consistent with all rules and regulations.
• Reviewing coding and billing strategies while implementing quality assurance processes.
• Understanding charge master set up 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 experience as a supervisor, lead worker, team lead, or project lead.
• Five (5) years of billing, coding, or revenue collection and integrity experience, including experience with 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 options available
• Comprehensive health insurance
• Retirement savings plan
• Paid holidays and vacation
• Professional development opportunities