Manager, Payment Integrity (RN & Coding Certified)

Top Echelon
  • Frisco, TX
  • Remote
  • $100,000–$110,000 Per Year
  • Instant Apply
1 day ago

Job Description

This job is posted on behalf of Pivotal Placement Services by Top Echelon.


Payment Integrity Manager (RN)


Fully Remote - Open to candidates located anywhere in the United States.

Make a Meaningful Impact on Healthcare Quality, Compliance, and Financial Integrity


Are you an experienced RN with a passion for identifying opportunities to improve healthcare outcomes, coding accuracy, and payment integrity? We're seeking a Payment Integrity Manager who will play a critical leadership role in ensuring claims accuracy, driving reimbursement integrity, and helping create a more efficient healthcare system.


In this role, you'll partner with clinical, coding, and operational teams to ensure payments are accurate, compliant, and aligned with industry standards. Your work will directly influence organizational performance while helping ensure healthcare resources are utilized appropriately and effectively.


What You'll Do



  • Lead payment integrity and revenue integrity initiatives across the organization.

  • Oversee audits and reviews focused on coding accuracy, reimbursement, and compliance.

  • Identify trends, recover revenue opportunities, and reduce payment inaccuracies.

  • Collaborate with clinical, coding, and operational stakeholders to improve processes and outcomes.

  • Analyze claims, coding practices, and reimbursement methodologies to identify areas for improvement.

  • Mentor and support team members while helping build a culture of continuous improvement.


What Makes You a Great Fit


✅ Active RN license in your state of employment


✅ Current coding certification (CPC, CCS, RHIT, or equivalent)


✅ Experience in:



  • Payment Integrity

  • Revenue Integrity

  • Medical Billing Coding

  • Auditing Compliance


✅ Clinical healthcare experience


✅ At least 1 year of leadership or supervisory experience


Preferred Experience



  • DRG validation or review experience

  • Health plan, payer, managed care, or revenue cycle experience

  • Strong analytical and problem-solving skills


Why Join Us?



  • Competitive salary: $100,000-$110,000

  • Fully remote opportunity

  • High-visibility leadership role

  • Opportunity to influence organizational strategy and financial performance

  • Collaborative team environment focused on continuous improvement and innovation


If you're ready to combine your clinical expertise, coding knowledge, and leadership skills to make a measurable impact, we'd love to connect with you. Apply today.

Numbers & Facts

LocationFrisco, TX (
Remote
)
Salary$100,000–$110,000 Per Year

Skills

  • Analysis Skillsunmatched
  • Business Strategyunmatched
  • Code Reviewsunmatched
  • Continuous Improvementunmatched
  • Diagnosis-Related Group (DRG)unmatched
  • Financial Complianceunmatched
  • Financial Strategyunmatched
  • Health Planunmatched
  • Healthcareunmatched
  • Healthcare Qualityunmatched
  • Healthcare Reimbursementunmatched
  • Industry Standardsunmatched
  • Leadershipunmatched
  • Maintain Complianceunmatched
  • Managed Careunmatched
  • Medical Billingunmatched
  • Medical Codingunmatched
  • Mentoringunmatched
  • Operational Improvementunmatched
  • People Managementunmatched
  • Problem Solving Skillsunmatched
  • Process Improvementunmatched
  • Registered Nurse (RN)unmatched
  • Reimbursementunmatched
  • Team Playerunmatched
  • Trend Analysisunmatched

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