Director Professional Revenue Integrity

Job Description

Job Description

Director Professional Revenue Integrity

Start: 1/11/27

Pay : $160,000 - $180,000

Setting : Hybrid

Location : Houston, Texas 77024 (Relocation assistance provided)

Shift : Monday - Friday 8am - 5pm

Qualifications:

- Bachelor's Degree

- Ten (10) years of Physician/Professional Billing experience with at least five (5) years in a management level position for a large health system required.

- Extensive knowledge and experience with Epic EMR system, specifically with EPIC Resolute Billing with a large health system.

- Experience in Charge Capture, Charge Reconciliation, Charge Pricing, Charge Routing, and Reimbursement.

- Comprehensive understanding of healthcare billing and coding systems (e.g., HCPCS, ICD-10).

- Certification(s) preferred:

• Certified Professional Coder (CPC)
• Certified Medical Coder (CMC)
• Epic certification such as ARCR: Resolute Professional Billing Claims and Billing Readiness
• Project Management Professional (PMP)

Responsibilities:

• This position is responsible for overseeing and managing all aspects of professional service charges to secure the organization's revenue integrity. The Director, Professional Revenue Integrity is accountable for the execution of the leadership, development, vision, operational and fiscal management of the professional services revenue integrity department. This position maintains a thorough comprehension of revenue cycle processes including Charge Capture, Charge Reconciliation, Data Analytics, Performance Optimization, Pricing, Reimbursement and Professional Billing. Partnering with leadership in Revenue Cycle, Clinical Departments, Networking, and Finance is essential to revenue performance across the Physician Enterprise.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.