Manager, Payment Integrity (RN & Coding Certified)

Job Description

Job Description

This job is posted on behalf of Pivotal Placement Services by Top Echelon.

Fully Remote - Open to candidates located anywhere in the United States.

Are you an experienced RN with a passion for identifying opportunities to improve healthcare outcomes, coding accuracy, and payment integrity? We're seeking a Payment Integrity Manager who will play a critical leadership role in ensuring claims accuracy, driving reimbursement integrity, and helping create a more efficient healthcare system.

In this role, you'll partner with clinical, coding, and operational teams to ensure payments are accurate, compliant, and aligned with industry standards. Your work will directly influence organizational performance while helping ensure healthcare resources are utilized appropriately and effectively.

• Lead payment integrity and revenue integrity initiatives across the organization.
• Oversee audits and reviews focused on coding accuracy, reimbursement, and compliance.
• Identify trends, recover revenue opportunities, and reduce payment inaccuracies.
• Collaborate with clinical, coding, and operational stakeholders to improve processes and outcomes.
• Analyze claims, coding practices, and reimbursement methodologies to identify areas for improvement.
• Mentor and support team members while helping build a culture of continuous improvement.

✅ Active RN license in your state of employment

✅ Current coding certification (CPC, CCS, RHIT, or equivalent)

✅ Experience in:

• Payment Integrity
• Revenue Integrity
• Medical Billing & Coding
• Auditing & Compliance

✅ Clinical healthcare experience

✅ At least 1 year of leadership or supervisory experience

• DRG validation or review experience
• Health plan, payer, managed care, or revenue cycle experience
• Strong analytical and problem-solving skills

• Competitive salary: $100,000-$110,000
• Fully remote opportunity
• High-visibility leadership role
• Opportunity to influence organizational strategy and financial performance
• Collaborative team environment focused on continuous improvement and innovation

If you're ready to combine your clinical expertise, coding knowledge, and leadership skills to make a measurable impact, we'd love to connect with you. Apply today.