Interim Revenue Integrity Director

Overview

This role involves leading and overseeing all aspects of revenue integrity, including chargemaster (CDM) management, charge capture, billing compliance, and revenue optimization. The Director of Revenue Integrity and Chargemaster ensures that clinical services are accurately documented, coded, and billed in compliance with regulatory standards, while maximizing reimbursement and minimizing revenue leakage.

Responsibilities

Revenue Integrity Oversight

• Develop and lead the revenue integrity strategy across all service lines
• Identify and reduce revenue leakage through audits, analytics, and process improvement
• Monitor key performance indicators (KPIs) related to charge capture, denials, and reimbursement
• Collaborate with finance, compliance, coding, and clinical departments to ensure accurate revenue cycle processes

Chargemaster (CDM) Management

• Oversee maintenance, accuracy, and compliance of the hospital chargemaster
• Ensure CDM alignment with coding updates (CPT, HCPCS, ICD-10) and payer requirements
• Lead regular CDM reviews and updates to reflect regulatory and operational changes
• Partner with departments to validate pricing, descriptions, and billing logic

Compliance & Regulatory Adherence

• Ensure adherence to regulations from CMS, OIG, and other governing bodies
• Maintain compliance with federal and state billing guidelines and internal policies
• Lead internal and external audit responses related to billing and revenue integrity
• Implement corrective action plans based on audit findings

Charge Capture & Coding Collaboration

• Work closely with clinical and coding teams to ensure accurate documentation and code assignment
• Improve charge capture processes across inpatient, outpatient, and procedural areas
• Support clinical departments with education on documentation and charging practices

Leadership & Team Management

• Lead and mentor revenue integrity and CDM teams
• Establish departmental goals, performance standards, and staff development plans
• Foster cross-functional collaboration between clinical, financial, and IT teams

Technology & Systems Optimization

• Partner with IT to optimize revenue cycle systems, including EHR platforms such as Epic Systems
• Leverage data analytics tools to identify trends and improvement opportunities
• Support system upgrades, implementations, and revenue cycle enhancements

Requirements

Required Qualifications

• Bachelor’s degree in Healthcare Administration, Finance, Business, or related field (Master’s preferred)
• 7–10+ years of experience in healthcare revenue cycle, focusing on revenue integrity or CDM
• 3–5+ years of leadership or management experience
• Strong knowledge of chargemaster management, billing compliance, and reimbursement methodologies
• In-depth understanding of CPT, HCPCS, and ICD-10 coding systems
• Experience with hospital and/or health system operations
• Ability to work 25-50% onsite in Knoxville, TN

Preferred Qualifications

• Professional certifications such as Certified Revenue Integrity Professional (CRIP), Certified Professional Coder (CPC), or Certified Healthcare Financial Professional (CHFP)
• Experience with large health systems or academic medical centers
• Familiarity with payer contract modeling and reimbursement analytics

Key Success Attributes

• Integrity, passion, and ethics
• Strong collaboration skills
• Analytical and problem-solving abilities
• Initiative and strong drive for results
• Commitment to a team environment
• Well-developed written, verbal, and presentation communication skills
• Ability to self-motivate and self-direct
• Strong time management and organizational skills

Core Competencies

• High level of integrity and ethical judgment
• Effective communication
• Consistency and reliability
• Meeting standards

Compensation & Benefits

• Pay range: $85-100 per hour
• Retirement benefits including 401(k) with company match (eligibility after 90 days for full-time employees; after 250 hours for part-time employees)
• Medical, dental, vision, life, short/long term disability insurance
• Paid time off (PTO)

Physical Demands & Working Conditions

• Sitting, talking, hearing, and near vision required over 90% of the time
• Feeling required over 90% of the time; reaching about 50% of the time
• Ability to travel to field sites up to 15% of the time
• Work performed over 90% indoors with protection from weather
• Exposure to distracting or uncomfortable noise levels only in unusual situations

Location

This position requires 25-50% onsite work in Knoxville, Tennessee.