Revenue Integrity Manager

Overview

The Revenue Integrity Manager is responsible for overseeing and safeguarding the end-to-end revenue integrity framework for Boomerang Healthcare. This role ensures accurate charge capture compliant coding, audit readiness, and regulatory adherence across all states of operations. The Revenue Integrity Manager serves as the subject matter expert for state-specific Workers’ Compensation billing rules, therapy documentation compliance, pain management coding standards, NCCI/CCI edit governance, and external audit preparedness.

This is a remote role.

• Own and manage charge integrity programs across pain management, rehab therapy, and ancillary services.
• Perform state-specific Workers’ Compensation charge audits, ensuring compliance with jurisdictional billing rules, fee schedules, and payer requirements.
• Monitor and validate charge capture accuracy across:
  • Interventional pain procedures
  • Rehabilitation and therapy services
  • Evaluation & Management services
• Identify and mitigate revenue leakage, under-coding, over coding, and duplicate billing risks.
• Oversee coding compliance, therapy documentation, including:
  • Plan of care requirements
  • Timed vs. untimed code rules
  • Functional outcome reporting
  • Medical necessity standards
• Serve as the escalation point for complex coding determinations and documentation deficiencies.
• Own enterprise-wide NCCI and CCI edit governance, including:
  • Edit monitoring and updates
  • Appropriate modifier application
  • Edit override review and approval
• Collaborate with billing, coding, and IT teams to ensure accurate system configuration and preventive edit controls.
• Analyze edit-driven denials and implement root cause corrections
• Develop and maintain revenue integrity dashboards, including:
  • Charge error rates
  • Documentation compliance trends
  • Audit exposure metrics
  • NCCI/CCI denial trends
• Present findings and risk mitigation strategies to RCM leadership and executive stakeholders.
• Proactively identify high-risk service lines, providers, and states
• Assumes other responsibilities as appropriate to the position and organizational needs

• Bachelor’s degree in healthcare administration, business, or related field (master’s preferred)
• 7+ years progressive experience in:
  • Revenue Integrity
  • Coding Compliance
  • Audit Management

• Direct experience in Pain Management and Rehabilitation billing, with a strong Workers’ Compensation focus.
• Preferred
  
  Certifications:
  • CPC, CCS, or CCS-P required
  • CRC (Certified Revenue Cycle Professional) or CHC (Certified in Healthcare Compliance) Preferred
• Strong regulatory and payer knowledge
• Ability to translate compliance requirements into operational work flows in pain management, workers comp, or procedural-based specialties.
• Excellent analytical, communication, and leadership skills.

Compensation Range: $104,000 to $113,000 Annually

All compensation ranges are posted based on internal equity, job requirements, experience, and geographical locations.

• Amazing work/life balance
• Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
• 401(K) Plan with Employer Matching
• License & Tuition Reimbursements
• Paid Time Off
• Holiday Pay & Floating Holiday
• Employee Perks and Discount Programs
• Supportive environment to help you grow and succeed

Boomerang Healthcare (BHC) is a multidisciplinary and comprehensive team of experienced, committed healthcare providers that treat pain. Our team of doctors approaches each patient with one goal in mind: to help patients return to normal daily activities. We work with our patients to identify the cause of their pain and create a personalized treatment plan, recognizing that no two patients are alike, and neither is their pain.

Our providers create a comprehensive care plan, then monitor, manage and coordinate patient access to health services at BHC.

Boomerang Healthcare strives to be a diverse workforce that reflects, at all job levels, the patients we serve. We are an equal opportunity employer. Boomerang Healthcare is committed to compliance with the American Disabilities Act. If you require reasonable accommodation during the application process or have a question regarding an essential job function, please contact us.

Schedule:

Monday-Friday, 8am-5pm

""