Interim Revenue Integrity Director

Job Description

Job Description

Description:

ABOUT US

At e4health, we Empower Better Health. The e4health Team is on a relentless mission to care for those teams who care for others. We bring our passion, ingenuity, and expertise to every engagement. In joining our Team, we want your help to provide our customers with powerful solutions in the pursuit of quality, integrity, clinical and financial value across healthcare.

Our People make the difference. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. e4health solutions streamline clinical, financial, and health information data and workflows, optimize coding, quality, and clinical documentation integrity processes, and address health IT operational challenges to deliver material results for healthcare organizations across the country. Learn more about us at

POSITION SUMMARY

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

KEY RESPONSIBILITIES

Revenue Integrity Oversight

• Develop and lead the organization’s 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 the 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 Centers for Medicare & Medicaid Services (CMS), Office of Inspector General (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 & 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

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, with focus 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
• 25-50% onsite work - Knoxville, TN

PREFERRED QUALIFICATIONS

Professional certifications such as:

• Certified Revenue Integrity Professional (CRIP)
• Certified Professional Coder (CPC)
• 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 are required
• Demonstrates strong collaboration skills
• Has strong analytic and problem-solving abilities and techniques
• Exhibit consistent initiative with strong drive for results and success
• Demonstrate commitment to a team environment?
• Well-developed written, verbal, and presentation communication skills including deep listening and attention to detail
• Ability to self-motivate and self-direct
• Possess strong time management and organizational skills
• Commitment and adherence to company Core Values

CORE COMPETENCIES:

• High level of integrity & ethical judgement
• Communication
• Consistency and Reliability
• Meeting Standards

401(k) ELIGIBILITY e4health offers a retirement benefits package including 401(k) with company match.

• Full-time employees (contractors working full time hours included) will be eligible to contribute to a 401(k)-retirement account after successfully completing 90 days of employment.
• Part-time employees will be eligible to contribute to a 401(k)-retirement account after completing 250 hours of worktime.

The items listed below pertain to Full-Time Employees only (contractors working full time hours included)
BENEFITS: We offer an excellent salary, medical, dental, vision, life, short/long term disability insurance, and PTO policy. PHYSICAL DEMANDS OF THE ESSENTIAL FUNCTIONS: Sitting, talking, hearing and near vision are required over 90% of the time. Feeling is required over 90% of the time and reaching is required about 50% of the time. The ability to travel to field sites may be required up to 15% of the time.
WORKING CONDITIONS WHILE PERFORMING ESSENTIAL FUNCTIONS: Over 90% of the time is spent indoors, with protection from weather conditions. Exposure to noise levels that may be distracting or uncomfortable is present in only unusual situations.

Pay range for this position is $85-100/hr.

e4health is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.
At our organization, we believe in the principles of pay transparency to foster a fair and equitable workplace for all employees. In alignment with this commitment, we openly communicate salary ranges, bonus structures, and additional financial benefits associated with each position. We believe that transparency in compensation not only promotes trust and accountability but also helps mitigate wage gaps and biases. By providing clear and comprehensive information about compensation in our job descriptions, we aim to create a transparent and inclusive environment where all employees feel valued and respected. Join us in building a culture of fairness and transparency as we strive for excellence together.