Billing Integrity Manager

Job Summary

The Billing Integrity Manager is responsible for overseeing the accuracy, compliance, and overall quality of the organization’s billing processes. This role ensures that claims are submitted correctly, payer guidelines are followed, and revenue cycle workflows maintain the highest level of integrity and efficiency.

The Billing Integrity Manager works closely with billing teams, coding specialists, and operations leadership to identify errors, improve processes, reduce denials, and maintain compliance with payer and regulatory requirements.

Key Responsibilities

• Monitor billing processes to ensure accuracy, compliance, and adherence to payer guidelines
• Perform regular audits of claims, coding, and billing submissions
• Identify patterns in denials, rejections, and billing discrepancies
• Develop and implement corrective action plans to improve billing accuracy
• Work closely with coding, billing, credentialing, and operations teams to resolve issues
• Ensure compliance with CMS, commercial payer policies, and regulatory requirements
• Track and report billing accuracy metrics and revenue cycle KPIs
• Train billing staff on best practices, compliance updates, and workflow improvements
• Support leadership in revenue cycle strategy and process optimization
• Assist with payer audits, internal audits, and compliance reviews

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field preferred
• 5+ years of experience in medical billing, revenue cycle management, or healthcare finance
• 2+ years of leadership or supervisory experience preferred
• Strong knowledge of:  
  • Medical billing processes
  • Claims submission and denial management
  • Insurance payer guidelines
  • Revenue cycle workflows  
• Experience with EHR/EMR and billing systems
• Strong analytical and problem-solving skills
• Ability to identify trends and implement process improvements

Preferred Qualifications

• Experience with neurology, behavioral health, or specialty care billing
• Certifications such as:
  • CPB (Certified Professional Biller)
  • CPC (Certified Professional Coder)
  • CRCR (Certified Revenue Cycle Representative)

Skills

• Strong attention to detail
• Analytical and reporting skills
• Process improvement mindset
• Leadership and team collaboration
• Knowledge of healthcare compliance and payer regulations

Benefits

• Competitive salary
• Remote work environment
• Opportunities for growth within the revenue cycle leadership team
• Continuing education and professional development support