Manager, Revenue Integrity PB

The Manager of Revenue Integrity and Professional Billing is responsible for leading and overseeing physician billing revenue integrity functions across the UF Health enterprise. This role ensures accurate charge capture, compliant billing practices, optimization of professional fee reimbursement, and reduction of revenue leakage. The Manager collaborates closely with physician groups, coding, CDI, managed care, finance, compliance, information technology, Epic teams, and operational leaders to develop and implement enterprise-wide strategies that improve revenue cycle performance while ensuring regulatory compliance. The position serves as the operational leader for professional billing revenue integrity initiatives and is responsible for maintaining standardized workflows, monitoring key performance indicators, identifying revenue opportunities, and supporting enterprise transformation efforts related to professional billing. This role aligns with the broader UF Health Clinical Revenue Cycle strategy to standardize processes, improve financial performance, and support organizational growth. Activities such as physician billing charge review, RVU and PBB pricing oversight, PB Revenue Guardian edits, and standardization of physician billing workflows are identified enterprise priorities.

Education

• Bachelor’s degree in healthcare administration, Business Administration, Finance, Health Information Management, Nursing, Accounting, or related field.
• Seven (7+) years of experience in lieu of a degree.
• Master’s degree preferred.

Experience

• Minimum five (5) years of progressively responsible experience in healthcare revenue cycle, revenue integrity, hospital finance, compliance, charge capture, patient accounting, HIM, or related areas.
• Minimum three (3) years of leadership or management experience.
• Experience with academic medical centers and transplant programs strongly preferred.
• Epic professional billing/revenue integrity functionality experience a must.

License/Certification/Registration

• Certified Healthcare Revenue Integrity (CHRI) preferred.
• Certified Professional Medical Auditor (CPMA) preferred.
• Certified Healthcare Compliance (CHC) preferred.
• Certified Professional Coder (CPC) preferred.
• Certified Coding Specialist (CCS) preferred.
• Certified Revenue Cycle Representative (CRCR) preferred.
• Registered Health Information Administrator (RHIA) preferred.
• Registered Health Information Technician (RHIT) preferred.

Other Qualifications

• Extensive knowledge of professional billing, charging, reimbursement methodologies, and revenue cycle operations.
• Strong understanding of Medicare, Medicaid, commercial payer regulations, and revenue integrity best practices.
• Knowledge of charge capture workflows, fee schedule management, claims processing, denials management, and reimbursement analysis.
• Ability to interpret regulatory requirements and translate them into operational processes.
• Ability to manage multiple priorities and lead through organizational change.
• Provider-based billing concepts and compliance.
• Professional coding and reimbursement principles.