Manager, Revenue Cycle

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

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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.

• 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.

• 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, Slicer Dicer) 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.

• 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…