Medical Revenue Manager | $88/hr Remote
Overview
We are looking for an experienced revenue integrity professional to oversee charge capture and ensure billing compliance, while also collaborating with an AI research lab to evaluate and improve AI tools designed to optimize revenue performance. This remote role blends hands-on revenue cycle management with cutting-edge AI evaluation. You'll help shape the future of healthcare AI by applying your expertise in charge integrity and CDM management.
What You'll Do9
- 1Lead charge capture and revenue integrity functions to guarantee accurate and compliant charge submission across clinical departments.
- 2Assess AI-generated outputs for charge reviews, coding suggestions, and revenue alerts to verify their accuracy and regulatory adherence.
- 3Perform regular charge audits to uncover missed charges, duplicates, and other capture errors, then devise corrective action plans.
- 4Maintain and update the charge description master (CDM), ensuring charge codes, revenue codes, and pricing are correct and current.
- 5Analyze charge patterns to pinpoint revenue leakage opportunities and implement targeted improvements.
- 6Work closely with clinical, coding, and billing teams to resolve discrepancies and streamline workflows.
- 7Track key metrics such as charge lag times, capture accuracy rates, and compliance findings, and report on performance.
- 8Provide structured feedback on AI outputs to help train and refine the machine learning models.
- 9Ensure all processes comply with CMS billing guidelines, OIG work plan priorities, and payer-specific requirements.
Requirements7
- 15+ years of experience in charge capture, charge integrity, revenue integrity, or healthcare compliance roles.
- 2Deep knowledge of CDM management, revenue codes, charge capture workflows, and billing compliance standards.
- 3Strong understanding of CMS billing guidelines, Medicare Part A/B rules, and OIG compliance requirements.
- 4Proficiency with charge capture systems, EHR platforms, and revenue integrity tools.
- 5Hands-on experience conducting charge audits and developing corrective action plans.
- 6Exceptional written and verbal English communication skills, with a high attention to detail.
- 7Preferred: CPC, CCS, CHFP, or CRCS credential; experience with 340B drug program charge capture; background in hospital or health system revenue integrity; familiarity with AI tools and evaluating AI-generated billing content.
Who Should Apply
This role is perfect for a seasoned revenue integrity manager who thrives at the intersection of healthcare compliance and technology. You have deep expertise in charge capture workflows and CDM management, and you're excited to apply your knowledge to train and evaluate AI systems. You are detail-oriented, collaborative, and comfortable providing structured feedback to improve machine learning models.
Salary Insight
$88 per hour, based on an hourly engagement. No additional compensation details provided.
Application Tip
When applying, highlight specific examples of how you've identified revenue leakage or improved charge capture accuracy in a healthcare setting. If you have experience working with AI tools or providing feedback on automated systems, mention that explicitly to show your adaptability.
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