Director, Revenue Integrity

OverviewThe Director of Revenue Integrity provides enterprise-wide leadership over charge capture, revenue integrity edit operations, chargemaster (CDM) operations, and charge/revenue reconciliation across all facilities and service lines. This leader is accountable for establishing standardized policies, decision rights, and internal controls that reduce variation, prevent revenue leakage, and maintain audit-ready compliance through disciplined build/change management, proactive monitoring, and closed-loop issue resolution. The Director partners withclinical departments, Finance, Compliance, Information Technology (IT), Coding, Billing, Follow-Up, and RCM Business Support to strengthen governance, reporting, and execution delivering measurable net revenue protection and enterprise standardization. QualificationsEducation: Bachelor’s degree in Healthcare Administration, Finance, Business, or a related field required.• Master’s degree (e.g., MHA, MBA) preferred.• Experience: Minimum of 7 to 10 years of progressive leadership experience in healthcare revenue cycle, revenue integrity, or related functions.• Demonstrated experience leading:Revenue Integrity operationsCharge capture programsChargemaster (CDM) managementRelated revenue cycle functions in a complex healthcare environment• Experience working within hospital revenue cycle operations.• License/Certification/Registration: Preferred certifications include:CHRI (Certified Healthcare Revenue Integrity Professional)CCS (Certified Coding Specialist)CPC (Certified Professional Coder)CRCR (Certified Revenue Cycle Representative)RHIA (Registered Health Information Administrator)RHIT (Registered Health Information Technician)CHC (Certified in Healthcare Compliance)• Demonstrated expertise in:Team leadership and talent developmentCoaching and succession planningBuilding high-performing teams• Executive-ready communication skills, including:Written communicationVerbal communicationFacilitation and presentation skillsExecutive stakeholder engagement• Strong change leadership capabilities with a continuous improvement mindset.• Demonstrated performance management discipline, including:Key Performance Indicators (KPIs)Operational cadenceAccountability frameworks• Experience providing enterprise governance and decision-making leadership for:Charge capture processesRevenue integrity editsChargemaster (CDM) standardsRevenue cycle controls• Proven ability to influence and collaborate across:Clinical operationsFinance departmentsCompliance teamsRevenue cycle leadershipOperational stakeholders• Strong skills in:Data-driven prioritizationStructured problem solvingRevenue leakage preventionOperational optimization• Ability to navigate escalations and complex issues within matrixed healthcare organizations.• Experience building closed-loop feedback mechanisms between upstream and downstream revenue cycle teams.• Deep expertise in:Charge capture workflowsRevenue integrity operating modelsFacility and service-line revenue processes• Strong understanding of:Revenue integrity edit conceptsPre-bill edit operationsDefect identification and triageRoot-cause analysis and resolution methodologies• Knowledge of reimbursement methodologies and the impact of charge structure on:Billing accuracyClaim editsReimbursement outcomesPayment optimization• Demonstrated experience with Chargemaster (CDM) management.• Working knowledge of:National Correct Coding Initiative (NCCI) editsCharge and coding compliance conceptsRevenue cycle regulatory requirementsRevenue integrity best practices• Strong technology fluency with experience using:EHR charge build toolsChargemaster (CDM) and pricing repositoriesReconciliation and variance analytics toolsRevenue cycle reporting platformsOperational dashboards and analytics solutions• Strong analytical, operational, compliance, and leadership skills with a focus on revenue optimization, governance, regulatory compliance, and continuous process improvement.