System Revenue Integrity Manager at Movera

Tupelo, Mississippi, United States -

Full Time

Start Date

Immediate

Expiry Date

16 Feb, 26

Salary

0.0

Posted On

18 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Revenue Cycle Management, Billing Practices, Data Analysis, Compliance Oversight, Relationship Management, Financial Integrity, Performance Monitoring, Team Leadership, Healthcare Administration, Payer Contracts, Denial Management, Automation Solutions, Standard Operating Procedures, Audit Defense, Reimbursement Strategies, Cash Posting, AR Workflows

Industry

Description

About the Company Druid City Vital Care, located in Northport, Alabama, is a leading home infusion therapy pharmacy dedicated to providing safe, convenient care for patients with both acute and chronic conditions. Our services allow patients to receive high-quality infusion therapy in the comfort of their homes or alternate care sites. Recognized for excellence in sterile drug compounding, Druid City Vital Care has earned top honors as the #1 franchise in the Vital Care network for 2023 and 2024. We are committed to delivering personalized support and comprehensive post-therapy follow-up, ensuring every patient receives exceptional care throughout their healthcare journey. About the Role: The Revenue Integrity Manager oversees billing and collections across all franchise locations, ensuring timely and accurate reimbursement. This role manages reimbursement operations, maintains a shadow accounting system to validate billing performance, and ensures full reconciliation of claims, payments, and adjustments. The position promotes regulatory compliance, identifies discrepancies, and escalates issues to protect financial integrity. The Revenue Cycle Manager also cultivates strong relationships with franchise partners, payers, and revenue cycle teams while developing a high-performing team to support efficient, customer-focused revenue cycle operations. Responsibilities: Shadow Book System Design & Financial Integrity Management * Build and maintain a real-time shadow revenue cycle tracking system that mirrors Vital Care’s billing and collections activities. * Ensure accurate mapping of the entire claim’s lifecycle, including submission, adjudication, denials, appeals, payments, write-offs, refunds, and patient responsibility. * Establish automated reporting, reconciliation routines, and data validation processes to identify discrepancies, revenue leakage, and opportunities for corrective action. * Support audit defense, contract validation, and financial due diligence activities. Revenue Cycle Analytics, Reporting & Performance Monitoring * Develop daily, weekly, and monthly dashboards measuring collections, AR aging, denial trends, and cash posting variances. * Prepare fiscal period performance review packages for leadership, including benchmarking against industry norms and payer-specific outcomes. * Analyze revenue cycle data to identify risks, trends, and opportunities for increased reimbursement. * Present detailed findings to leadership (including CFO), highlighting systemic issues, payer behavior, underpayments, compliance concerns, and recommendations for improvement. Revenue Integrity & Compliance Oversight * Ensure billing practices align with payer contracts, federal/state regulations, franchise agreements, and internal policies. * Oversee secure handling of PHI/PII and ensure adherence to HIPAA, CMS, and audit standards. * Develop and implement processes to minimize revenue loss, strengthen revenue capture, and ensure billing compliance across all franchise locations. * Support franchise locations in maintaining compliant financial hardship, billing, and collection procedures. Stakeholder, Vendor & Billing Partner Management * Serve as the primary liaison with Vital Care billing leadership, outsourced billing partners, and third-party RCM vendors. * Monitor service levels, claim turnaround times, denial management performance, and cash posting accuracy. * Escalate unresolved issues or high-risk discrepancies to legal, compliance, or executive leadership. * Maintain productive relationships with franchisor RCM teams, system support resources, and franchise leaders. Revenue Cycle Optimization & Continuous Improvement * Lead initiatives to improve claim accuracy, reduce days in AR, strengthen payer reimbursement, and minimize denials and adjustments. * Collaborate with intake, authorization, clinical, operations, system support, and finance teams to ensure data integrity from referral through cash application. * Deploy automation solutions (RPA, ETL, data integration tools) to streamline workflows, improve accuracy, and reduce manual burden. * Develop and execute processes to improve franchise profitability based on payer reimbursement rates and cost-of-goods trends. Team Leadership & Operational Excellence * Oversee franchise billing and collection staff, ensuring proper training, process adherence, and performance management. * Create, implement, communicate, and maintain Standard Operating Procedures (SOPs) for all revenue cycle functions. * Build a high-performing team culture focused on accuracy, timeliness, compliance, and outstanding customer service. * Set departmental goals, monitor productivity, and hold team members accountable for achieving operational targets. Qualifications * Bachelor’s degree in finance, Healthcare Administration, Accounting or related field * Minimum of 3-5 years of healthcare revenue cycle experience * Strong understanding of payer rules, EOBS/ERA posting, denial management, AR workflows, and riembursement strategies. * Experience with Excel, SQL, Power BI/Tableau, or other analytics tools. * Demonstrated ability to build systems from scratch, audit financial flows, and challenge external * assumptions with data. * Excellent communication and relationship management skills, especially in vendor/franchise * environments. Preferred * Master's degree in finance, Healthcare Administration, Accounting or related field * Healthcare revenue cycle management experience in specialty pharmacy infusion, DME, or home health. Commitment to Diversity and Inclusivity At Druid City Vital Care, we believe that diversity and inclusivity are essential to delivering exceptional care and fostering innovation. We are committed to creating a workplace where every individual is respected, valued, and empowered—regardless of race, ethnicity, gender identity, age, ability, or background. Our approach includes: * Inclusive Hiring Practices: Ensuring equal opportunities for all candidates. * Ongoing Education: Providing training to promote cultural competence and eliminate bias. * Collaborative Environment: Encouraging diverse perspectives to strengthen patient care and organizational success. By embracing diversity and inclusion, we aim to reflect the communities we serve and build a culture of belonging for our employees and patients alike.

Responsibilities

The Revenue Integrity Manager oversees billing and collections across all franchise locations, ensuring timely and accurate reimbursement. This role manages reimbursement operations, maintains a shadow accounting system to validate billing performance, and ensures full reconciliation of claims, payments, and adjustments.