Revenue Integrity Manager – CDM Operations

Job not on LinkedIn

🕒 July 24

🏄 California – Remote

🏄 California – Remote

💵 $80 / hour

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

⚙️ Operations

👻 Ghost score 26%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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The Wilshire Group

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💼 Consulting

Healthcare • Healthcare Insurance • Consulting

The Wilshire Group is a consultancy firm that specializes in optimizing revenue cycle operations and IT solutions for the healthcare industry. They provide services in patient access, health information management, revenue integrity, and billing for both hospital and professional settings. The firm focuses on enhancing financial experiences by partnering with clients to solve complex challenges at the intersection of operations and technology. The Wilshire Group is dedicated to helping organizations maximize their EHR investments and improve revenue recognition and workflow optimization, ensuring consistent and proven results.

📋 Description

• Lead the strategic oversight, maintenance, and optimization of the Charge Description Master (CDM) • Partner with operational, finance, clinical, compliance, and IT teams to improve revenue integrity processes • Monitor and maintain compliance with CPT, HCPCS, ICD-10, CMS, and payer requirements • Conduct CDM audits and identify opportunities for charge capture accuracy and reimbursement improvement • Manage annual and ongoing code set updates, pricing reviews, and regulatory changes • Analyze reimbursement trends and recommend operational and pricing enhancements • Support system implementations, upgrades, and integrations impacting CDM workflows, including Epic • Develop best practices and provide guidance to department leaders on CDM governance and charge capture processes • Assist with resolving billing discrepancies, denial trends, and compliance risks • Drive process improvement initiatives that enhance operational efficiency and financial performance

🎯 Requirements

• Bachelor’s degree in Healthcare Administration, Health Information Management, Finance, or related field • 5+ years of experience in Revenue Integrity, CDM management, hospital billing, or healthcare reimbursement • Strong working knowledge of CPT, HCPCS, ICD-10, and payer reimbursement methodologies • Experience working within hospital billing and physician billing (Epic required) • Strong analytical, organizational, and problem-solving skills • Ability to manage multiple priorities in a fast-paced consulting environment • RHIA, RHIT, CPC, CCS, or similar certification preferred • Experience supporting large healthcare systems or consulting engagements preferred • Advanced Excel, reporting, or data analysis skills preferred • Experience leading charge capture optimization or revenue integrity initiatives preferred

🏖️ Benefits

• Flexible, remote work environment • Opportunity to work with nationally recognized healthcare systems • Collaborative and highly experienced consulting team • Meaningful, high-impact healthcare projects • Fast-moving environment where your expertise is valued and visible