Revenue Cycle Compliance Manager

At Revere Health, we believe there is a better path to healing and healthcare maintenance, and we’re working on this mission—one patient at a time. We’re a national leader in a movement called value-base care which aims to improve treatment outcomes and keep costs down. Our internal culture is one that promotes respect and consistently recognizes the impact that individual employees have on the mission of the organization.

The Revenue Cycle Compliance Manager is responsible for building and leading the organization’s revenue cycle compliance program. This role ensures that coding, documentation, and billing practices are accurate, defensible, and compliant across both internal teams and external revenue cycle partners. This position partners closely with Corporate Compliance, Legal, Physician Leadership, and Revenue Cycle Operations to identify risk, drive improvement, and protect organizational revenue.

• Leads the Revenue Cycle Compliance program across all professional billing operations.
• Develops and manages risk-based audit plans for coding, documentation, modifiers, and medical necessity.
• Supervises Compliance Auditors, AR Compliance Auditors and Analysts.
• Performs trend analysis of coding accuracy, denial patterns, payer audits, and reimbursement risk.
• Serves as the primary operational contact for payer audits, refunds, and external compliance reviews.
• Partners with Corporate Compliance and Legal on corrective action plans and self disclosure decisions.
• Provides compliance risk reporting to Revenue Cycle leadership and executive stakeholders.
• Collaborates with physician leadership to address documentation and coding risks.

• Five or more years of experience in healthcare revenue cycle, coding, or auditing
• At least 3 years of experience in compliance, audit, or revenue integrity leadership
• Strong knowledge of CPT, ICD-10-CM, HCPCS, E and M guidelines, modifiers, NCCI edits, and medical necessity rules
• Experience working with payer audits, provider audits and recoupment activity
• Prior supervisory and/or leadership experience
• CPMA Required

Monday-Friday 8am to 5pm Hybrid