Manager-Revenue Integrity - PB

You were meant for Hopkins! Come see why the Johns Hopkins All Children’s Hospital is a world-renowned leader in patient care, serving the greater St. Peterburg’s community and patients from all across the globe. Our friendly and knowledgeable staff teams provide support throughout our many specialty departments and centers, from primary visits to emergency care. What Awaits You?

• Career growth and development
• Diverse and collaborative working environment
• Affordable and comprehensive benefits package including Tuition Reimbursement

Our competitive Benefit Package is designed to support the well-being and financial security of our employees. You can explore the details of our benefits offering by visiting the following link: Johns Hopkins All Children's Hospital | Your benefits virtually (mybenefitsjhhs.com) Position Summary: The Revenue Integrity Manager – Professional Billing is responsible for leading and overseeing professional billing revenue integrity operations across Johns Hopkins Hospital. This role ensures accurate charge capture, compliant coding practices, denial prevention, and optimization of reimbursement performance. The Manager supervises a team of Revenue Integrity analysts and auditors and partners cross-functionally with physicians, coding, compliance, IT, finance, billing operations, and affiliate hospital partners to reduce revenue leakage and strengthen financial controls. This position plays a critical leadership role in monitoring key performance indicators, implementing corrective action plans, and driving continuous process improvement across the professional billing revenue cycle. Essential Functions:

• Lead professional billing revenue integrity operations, including charge capture oversight, coding accuracy, and denial prevention strategies.
• Supervise and develop a team of 5–7 direct reports, including work assignment, performance monitoring, coaching, and professional development.
• Analyze denial trends and reimbursement patterns; identify root causes and implement sustainable corrective action plans.
• Develop and maintain standardized professional billing workflows, charge reconciliation processes, and revenue integrity controls.
• Partner with Coding, Billing, Compliance, IT, and Clinical Operations to ensure alignment of documentation, Epic workflows, and payer requirements.
• Monitor and report on revenue integrity KPIs (denial rates, charge lag, billing accuracy, reimbursement variance).
• Provide provider and department education on documentation requirements, coding standards, and payer policies.
• Support internal and external audits, payer reviews, and compliance initiatives.
• Escalate systemic revenue risks to leadership and participate in strategic revenue cycle planning initiatives.
• Oversee denial management strategy and ensure consistent follow-up and resolution of high-risk trends.

Job Requirements:

• Bachelor’s degree preferred. Equivalent experience may be considered.
• Active coding certification required (CPC, CCS, CCS-P, COC, or equivalent).
• Minimum 5 years of progressive experience in professional billing, revenue integrity, coding, or revenue cycle operations.
• Minimum 3 years of leadership or supervisory experience.
• Advanced knowledge of professional billing workflows, charge capture processes, payer reimbursement methodologies, and denial management.
• Strong understanding of CPT, HCPCS, ICD-10-CM, and modifier application.
• Proficiency in Epic (Resolute PB, Charge Router, Reporting Workbench, SlicerDicer) and data analysis tools.
• Demonstrated ability to analyze complex data sets and implement operational improvements.
• Strong written and verbal communication skills with ability to engage physicians, operational leaders, and executives.

Preferred Experience:

• Certification in healthcare compliance, auditing, or revenue cycle management (CPMA, CHC, CRCR, etc.).
• Epic PB certification preferred.
• Experience leading charge capture optimization, denial reduction initiatives, and workflow redesign.
• Experience partnering with multi-specialty physician groups and affiliate hospital partners.
• Demonstrated success in improving reimbursement performance and reducing revenue leakage.
• Experience presenting operational and financial findings to senior leadership.

Hours: Full time (40 hours) Day Shift No weekends Location: Full-time Remote Salary Range: Minimum 30.64/hour - Maximum 49.02/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices. Johns Hopkins Health System and its affiliates are drug-free workplace employers.