UT Southwestern Medical Center
Manager, Revenue Integrity
UT Southwestern Medical Center, Dallas, Texas, United States, 75215
Manager, Revenue Integrity
UT Southwestern Medical Center – Decision Support Department.
Job Summary UT Southwestern has a new employment opportunity available for a Manager, Revenue Integrity within the Decision Support Department. The successful candidate will include but will not be limited to the following responsibilities:
Must be a Registered Nurse.
Provide leadership, guidance, and effectively manage the day-to-day operations of the Revenue Integrity Analyst and Audit Nurses.
Ensure timely review, appeal, and follow up.
Analyze variances, rejections, and denials information to identify problems, trends and develop feedback and reports to be presented to senior management and clinical department heads.
Hospital Billing/Charge Accuracy audits (prospectively or retrospectively), Insurance Defense audits, select Focus audits, Billing Compliance and Charge Capture audits.
Provide support to Patient Financial Services, HIM/Coding and other departments to promote sound revenue integrity. Analyze data and develop an overall approach for trending issues, report findings, continued education, and training (as the content experts) for PFS and clinical departments.
Provide management planning, development, and guidance to staff within the roles of Audit and Chargemaster.
Analyze data and develop an overall approach for trending issues, report findings, applying timely and constructive feedback, continued education, and training (as the "content experts") for Revenue Integrity, clinical departments, nursing units/departments. Prepare department summaries based on audit findings and work closely with applicable staff/management for continued performance improvement and ensure compliance with Medicare/Medicaid regulations, Managed Care contractual agreements, and the applicable policies of UT Southwestern University Hospital.
Benefits
PPO medical plan, available day one at no cost for full-time employee-only coverage.
100% coverage for preventive healthcare – no copay.
Paid Time Off, available day one.
Retirement Programs through the Teacher Retirement System of Texas (TRS).
Paid Parental Leave Benefit.
Wellness programs.
Tuition Reimbursement.
Public Service Loan Forgiveness (PSLF) Qualified Employer.
Learn more about these and other UTSW employee benefits!
Experience and Education Required
Education: Bachelor’s Degree from a recognized college or university in business, healthcare or a closely related field or 10 years’ experience within the revenue cycle and coding.
Experience: 10 years’ experience in the hospital setting, healthcare industry or coding with a focus in one or more of the following areas: coding, charge integrity; charge reconciliation; charge compliance; charge auditing; CDM management or Audit Nursing and 1-year supervisory experience.
Licenses and Certifications: RN (Registered Nurse) or CPHT (Certified Pharmacy Technician) or PTCB (Certified Compound Sterile Preparation Technician) or CHRI (Certified Healthcare Revenue Integrity professional) through NAHRI or RHIA (Registered Health Information Administrator) through AHIMA or RHIT (Registered Health Information Technician) through AHIMA or CCS (Certified Coding Specialist) through AHIMA or COC (Certified Outpatient Coding professional) through AAPC or CPC (Certified Professional Coder) through AAPC.
Preferred
Experience with EPIC HB/PB.
Job Duties
Oversee all revenue integrity staff with a focus on charge capture and charge reconciliation activities. Coordinate efforts with Sr. Nurse Auditor and Sr. Chargemaster Coordinator to lead audit/charge evaluations according to RI auditing guidelines and review findings, documentation standards and recommendations for improvement.
Analyze charge capture audit reports to verify that appropriate charges have been posted to patient accounts according to diagnosis and related procedure codes and that revenue has been routed/recorded in the appropriate department/cost center.
Coordinate efforts with Sr. Nurse Auditor and Sr. Chargemaster Coordinator to ensure all staff are informed of all regulatory changes for both hospital billing and professional billing. Conduct necessary training and maintain up-to-date policies and assist departments with the charge reconciliation process.
Advise service line leaders and their staff on proper usage of charge codes; identify opportunities for capturing additional revenue in accordance with payer guidelines; develop specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections for both hospital and professional billing.
Stay abreast of ongoing compliance trends and developments, report new developments to the department, and plan and present in‑services to nursing, physician, and other clinical personnel regarding processes, updates and reviews related to audit findings and/or regulatory compliance.
Security and EEO Statement Security This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.
EEO UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.
Job Posting Details Primary Location:
Texas-Dallas-5323 Harry Hines Blvd Work Locations:
5323 Harry Hines Blvd Job Title:
Professional & Executive Organization:
844106 – Decision Support Schedule:
Full-time Shift:
Day Job Employee Status:
Regular Job Type:
Standard Job Level:
Manager with Direct Reports Job Posting Date:
Oct 23, 2025
#J-18808-Ljbffr
Job Summary UT Southwestern has a new employment opportunity available for a Manager, Revenue Integrity within the Decision Support Department. The successful candidate will include but will not be limited to the following responsibilities:
Must be a Registered Nurse.
Provide leadership, guidance, and effectively manage the day-to-day operations of the Revenue Integrity Analyst and Audit Nurses.
Ensure timely review, appeal, and follow up.
Analyze variances, rejections, and denials information to identify problems, trends and develop feedback and reports to be presented to senior management and clinical department heads.
Hospital Billing/Charge Accuracy audits (prospectively or retrospectively), Insurance Defense audits, select Focus audits, Billing Compliance and Charge Capture audits.
Provide support to Patient Financial Services, HIM/Coding and other departments to promote sound revenue integrity. Analyze data and develop an overall approach for trending issues, report findings, continued education, and training (as the content experts) for PFS and clinical departments.
Provide management planning, development, and guidance to staff within the roles of Audit and Chargemaster.
Analyze data and develop an overall approach for trending issues, report findings, applying timely and constructive feedback, continued education, and training (as the "content experts") for Revenue Integrity, clinical departments, nursing units/departments. Prepare department summaries based on audit findings and work closely with applicable staff/management for continued performance improvement and ensure compliance with Medicare/Medicaid regulations, Managed Care contractual agreements, and the applicable policies of UT Southwestern University Hospital.
Benefits
PPO medical plan, available day one at no cost for full-time employee-only coverage.
100% coverage for preventive healthcare – no copay.
Paid Time Off, available day one.
Retirement Programs through the Teacher Retirement System of Texas (TRS).
Paid Parental Leave Benefit.
Wellness programs.
Tuition Reimbursement.
Public Service Loan Forgiveness (PSLF) Qualified Employer.
Learn more about these and other UTSW employee benefits!
Experience and Education Required
Education: Bachelor’s Degree from a recognized college or university in business, healthcare or a closely related field or 10 years’ experience within the revenue cycle and coding.
Experience: 10 years’ experience in the hospital setting, healthcare industry or coding with a focus in one or more of the following areas: coding, charge integrity; charge reconciliation; charge compliance; charge auditing; CDM management or Audit Nursing and 1-year supervisory experience.
Licenses and Certifications: RN (Registered Nurse) or CPHT (Certified Pharmacy Technician) or PTCB (Certified Compound Sterile Preparation Technician) or CHRI (Certified Healthcare Revenue Integrity professional) through NAHRI or RHIA (Registered Health Information Administrator) through AHIMA or RHIT (Registered Health Information Technician) through AHIMA or CCS (Certified Coding Specialist) through AHIMA or COC (Certified Outpatient Coding professional) through AAPC or CPC (Certified Professional Coder) through AAPC.
Preferred
Experience with EPIC HB/PB.
Job Duties
Oversee all revenue integrity staff with a focus on charge capture and charge reconciliation activities. Coordinate efforts with Sr. Nurse Auditor and Sr. Chargemaster Coordinator to lead audit/charge evaluations according to RI auditing guidelines and review findings, documentation standards and recommendations for improvement.
Analyze charge capture audit reports to verify that appropriate charges have been posted to patient accounts according to diagnosis and related procedure codes and that revenue has been routed/recorded in the appropriate department/cost center.
Coordinate efforts with Sr. Nurse Auditor and Sr. Chargemaster Coordinator to ensure all staff are informed of all regulatory changes for both hospital billing and professional billing. Conduct necessary training and maintain up-to-date policies and assist departments with the charge reconciliation process.
Advise service line leaders and their staff on proper usage of charge codes; identify opportunities for capturing additional revenue in accordance with payer guidelines; develop specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections for both hospital and professional billing.
Stay abreast of ongoing compliance trends and developments, report new developments to the department, and plan and present in‑services to nursing, physician, and other clinical personnel regarding processes, updates and reviews related to audit findings and/or regulatory compliance.
Security and EEO Statement Security This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.
EEO UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.
Job Posting Details Primary Location:
Texas-Dallas-5323 Harry Hines Blvd Work Locations:
5323 Harry Hines Blvd Job Title:
Professional & Executive Organization:
844106 – Decision Support Schedule:
Full-time Shift:
Day Job Employee Status:
Regular Job Type:
Standard Job Level:
Manager with Direct Reports Job Posting Date:
Oct 23, 2025
#J-18808-Ljbffr