RN Payment Integrity Manager

Leading a team of Medical Bill Reviewers, the full-time RN Payment Integrity Manager will oversee high-quality facility bill audits, ensuring accuracy and compliance while managing operational workflows in a remote setting. Key responsibilities Directly manage and coach a team of Medical Bill Reviewers, monitoring performance metrics and ensuring timely completion of audits Serve as the clinical authority for audit quality, reviewing escalated cases and maintaining clinical review standards Collaborate with cross-functional teams to optimize audit workflows and contribute to client-facing reporting and escalations Required qualifications Must hold an active RN license or higher-level clinical license 5+ years of experience in medical bill review, facility coding, or clinical auditing, with at least 2+ years in a leadership role Deep expertise in Itemized Bill Review (IBR) and facility claim auditing At least one relevant coding/audit certification preferred (CPC, CIC, CRC, CPMA, etc.) Strong knowledge of national coding guidelines and HIPAA/PHI compliance standards