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Revenue Integrity Manager

Summary

This position reports to the Director of Revenue Cycle. This position oversees charge integrity, Charge Description Master (CDM) maintenance, and related revenue cycle support functions for Samaritan Medical Center, Samaritan Medical Practice, and Clifton Fine Hospital. This role is responsible for promoting accurate charge capture, compliant billing practices, data integrity, and effective alignment across clinical, financial, and operational workflows. The Revenue Integrity Manager collaborates with Revenue Cycle, Patient Financial Services, Patient Access, Information Technology, clinical departments, and vendor partners to identify and resolve issues impacting charge accuracy, claim quality, reimbursement, and front-end revenue cycle performance, while supporting ongoing system integration, technology optimization, workflow improvement, testing, validation, and operational readiness across an evolving technical environment.

Duties and Responsibilities

• Lead oversight of charge integrity and Charge Description Master (CDM) maintenance activities ensuring timely processing of charge additions, deletions, pricing updates, and CPT/HCPCS code changes.
• Perform daily review and analysis of charging errors, claim issues, and revenue cycle discrepancies; investigate root causes and recommend corrective actions related to registration, coding, charge entry, cash collection, posting, account balance issues.
• Collaborate with Charge Integrity Auditors, Revenue Cycle, Patient Access, Information Technology, and operational departments to identify, analyze, and resolve CDM-related and front-end claim submission issues.
• Support annual and ongoing system build, maintenance, testing, and validation activities related to CDM, price adjustments, system enhancements, and upgrades to ensure charge accuracy, functionality, compliance, and transparency are maintained.
• Lead CDM Committee meetings and coordinate with appropriate clinical, operational, and financial stakeholders to ensure representation, communication, and follow-through on charge integrity initiatives.
• Partner directly with clinical departments and Samaritan resources to align inpatient, ancillary, clinical, billing, and financial systems with standardized CDM maintenance processes and quarterly/annual regulatory updates.
• Observe, evaluate, and document clinical and operational workflows that impact charge design, system build, and revenue cycle outcomes; develop and implement process improvements to strengthen charge capture and data integrity.
• Evaluate consistency of charge and related data across clinical and financial systems to ensure accurate interfacing, standardization, and regulatory compliance.
• Maintain responsibility for the accuracy and integrity of claim form-related charge data and serve as a resource to support of accurate charge master maintenance.
• Perform report scrubbing, data validation, and issue identification to support revenue cycle accuracy, operational oversight, and workflow improvement.
• Support Quadax cleaning, reconciliation, and related follow-up to improve claim quality, data integrity, and reimbursement outcomes.
• Serve as a primary operational point person for Patient Access vendor coordination, including issue escalation, workflow review, system optimization, and communication with internal and external stakeholders.
• Maintain shared operational ownership of AccuReg with the Director of Patient Access, including oversight of front-end workflows, error trends, and process improvement opportunities.
• Maintain shared operational ownership of Phreesia with Information Technology and Patient Access, including workflow alignment, functionality review, issue resolution, and implementation support.
• Collaborate with Revenue Cycle, Patient Access, Information Technology, and vendor partners to identify and resolve system, workflow, and data integrity issues impacting registration quality, claim submission, and reimbursement.
• Support Meditech Expanse readiness through review, cleanup, and standardization of charge, workflow, and system data to ensure accurate conversion and go-live preparedness.
• Participate in EMR planning, testing, validation, and post-go-live stabilization efforts to support accurate charge capture, compliant billing, system functionality, and revenue cycle performance.

Knowledge, Skills, and Abilities:

• Bachelor’s degree in Business Administration, Accounting, Health Care Information Technology, Computer Science or a related area and/or equivalent combination of training and experience
• Understanding of CPT/HCPCS, ICD‑10, UB‑04 billing, and payer reimbursement methodologies
• Proficiency with hospital billing systems, MediTech, and clearinghouse platforms
• Proficiency in working with complex and large volumes of data
• Excellent analytical, organizational, and problem‑solving skills
• Strong organizational and written/oral communication skills
• Ability to work independently and with little supervision

• Excellent ability to manage to deadlines
• Technical knowledge of all revenue generation sources, including CDM, Charge Capture, CDI, Coding and all other related issues.
• Ability to interpret a large volume of data and report it in a concise, meaningful manner.
• Minimum of three (3) years relevant experience in CDM Management or IT. Patient Accounting experience preferred
• Coding Certification (CPC, COC, CCA, CCS, and RHIT) Preferred
• Clinical experience a plus
• Charge Capture/Coding/Clinical Documentation analysis experience preferred
• Strong Excel Skills required

Samaritan is an Affirmative Action/Equal Opportunity Employer. Women, Minorities, Disabled, and Veterans are encouraged to apply.

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Samaritan is an Affirmative Action/Equal Opportunity Employer. Women, Minorities, Disabled, and Veterans are encouraged to apply.