The Wilshire Group logo
The Wilshire Group

Experience you can trust; results you can count on

Revenue Integrity Manager, CDM Operations

OperationsOperationsContractRemoteSeniorTeam 11-50H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

10 days ago

Salary

$80 / hour

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Revenue Integrity Manager, CDM Operations

The Wilshire Group

• 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, denials trends, and compliance risks • Drive process improvement initiatives that enhance operational efficiency and financial performance

Job 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 systems and EMR platforms (Epic preferred)
  • Strong analytical, organizational, and problem-solving skills
  • Ability to manage multiple priorities in a fast-paced consulting environment

Benefits

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

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