Director-Revenue Integrity; Remote Option-AZ

Staff Position Description

Position Title: Director of Revenue Integrity

Department: Revenue Integrity

Reports to: Senior Director of Revenue Cycle

Position

Purpose:

All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision to be among the kindest, highest quality health systems in the country.

The Director of Revenue Integrity is responsible for ensuring the organization accurately captures, charges, bills, and receives reimbursement for all services provided in a manner that is compliant with federal, state, payer, and regulatory requirements. This role serves as the primary leader for revenue integrity activities across Kingman Regional Medical Center, overseeing processes that ensure patients are billed only for services rendered, charges are supported by clinical documentation, and reimbursement is accurate and compliant with CMS and other payer regulations.

The Director provides strategic leadership and operational oversight for the Charge Description Master (CDM), charge capture and reconciliation, revenue compliance audits, regulatory reviews, denial prevention and management, underpayment recovery, and revenue integrity education. This position partners closely with Clinical Operations, Finance, Health Information Management, Coding, Patient Financial Services, and Information Systems to maintain the integrity of clinical and financial data throughout the revenue cycle.

The Director acts as a key advisor to executive leadership on revenue optimization opportunities, reimbursement risks, regulatory changes, and compliance initiatives that impact the organization's financial performance. Through proactive monitoring, analysis, and collaboration, this role safeguards organizational revenue, supports regulatory compliance, and promotes accurate reimbursement for both hospital and professional services.

• Provides leadership, direction, and oversight for the organization's Revenue Integrity program, ensuring accurate charge capture, compliant billing practices, and appropriate reimbursement for all hospital and professional services.
• Collaborates with clinical, operational, finance, patient financial services, health information management, coding, compliance, and information systems teams to ensure clinical services are accurately translated into compliant billable charges.
• Develops and implements revenue integrity auditing programs, including charge capture reviews, regulatory compliance audits, billing validation audits, and targeted departmental assessments.
• Analyzes revenue cycle performance, denial trends, audit findings, reimbursement variances, and payer payment activity to identify opportunities for revenue enhancement and operational improvement.
• Leads investigations and resolution of revenue-related system issues, charge discrepancies, and data integrity concerns impacting reimbursement, regulatory compliance, or financial reporting.
• Develops, monitors, and reports key revenue integrity metrics, providing actionable recommendations to leadership that improve revenue capture, reduce denials, and strengthen compliance.
• Provides education and training to clinical, operational, and revenue cycle staff regarding charge capture requirements, documentation standards, regulatory updates, billing compliance, and revenue integrity best practices.
• Establishes and maintains revenue integrity policies, procedures, and internal controls that support regulatory compliance, audit readiness, and financial stewardship.
• Oversees vendor relationships and performance associated with revenue integrity functions, including payer credentialing, reimbursement recovery, auditing, charge capture technology, and revenue cycle consulting services.
• Partners with organizational leadership to evaluate new services, technologies, procedures, and payer requirements to ensure proper charge structure, reimbursement methodology, and revenue cycle compliance prior to implementation with a commitment to continuous improvement by identifying opportunities to strengthen revenue processes, enhance reimbursement accuracy, improve compliance outcomes, and optimize the organization's financial performance.
• Performs other duties as assigned to support overall effectiveness of department and organization.

Education

Bachelor's degree in Healthcare Administration, Finance, Accounting, Business Administration, Health Information Management, or a related field required.

Experience

• Minimum of seven (7) years of progressively responsible healthcare revenue cycle experience, including charge capture, revenue integrity, reimbursement, billing compliance, denial management, coding, or patient financial services.
• Minimum of three (3) years of leadership experience managing revenue cycle, revenue integrity, reimbursement, or related healthcare financial operations.
• Demonstrated experience with Charge Description Master (CDM) management, charge capture…