DIRECTOR OF REVENUE INTEGRITY SKILLS, EXPERIENCE, AND JOB REQUIREMENTS

Updated: Mai 28, 2025 - The Director of Revenue Integrity possesses strong management skills, adept at making decisions and directing a diverse team to ensure effective operation. Demonstrates excellent organizational, interpersonal, and leadership qualities, coupled with adept negotiation and problem-solving skills to address complex issues. Boasts a proven track record in strategy development and business development, with deep knowledge of insurance regulations and an ability to communicate effectively across all levels of the organization.

Essential Hard and Soft Skills for a Standout Director of Revenue Integrity Resume
  • Financial Analysis
  • Revenue Cycle Management
  • Advanced Excel Skills
  • Coding and Billing Knowledge
  • Regulatory Compliance
  • Audit Techniques
  • Data Analytics
  • Contract Management
  • Healthcare Information Systems Proficiency
  • Strategic Planning
  • Leadership
  • Decision-Making
  • Problem-Solving
  • Communication
  • Interpersonal Skills
  • Negotiation
  • Adaptability
  • Organizational Awareness
  • Team Management
  • Strategic Thinking

Summary of Director of Revenue Integrity Knowledge and Qualifications on Resume

1. BA in Healthcare Administration with 10 Years of Experience

  • Strong working knowledge of the end-to-end revenue cycle, chargemaster, HIM, registration, coding, insurance verification, billing and claim processing, accounts receivable management and collections.
  • Ability to effectively communicate with internal and external customers, both verbal and written
  • Effectively train and mentor team members
  • Ability to work independently and make independent decisions in a fast-paced environment
  • Ability to manage centralized billing in a multiple location environment
  • Ability to read and organize insurance contracts
  • Strong task management and organizational skills, understanding priorities
  • Ability to complete analytical reports
  • Strong affinity for understanding large audience needs and ability to deal effectively with a diverse workforce and cross functional groups
  • Strong facilitative leadership and business problem-solving skills
  • Knowledge of value-based provider contract/agreements
  • Overall healthcare experience including ACA risk adjustment experience 

2. BA in Business Management with 8 Years of Experience

  • Experience in health care management, related field, or equivalent experience in revenue cycle operations. 
  • Experience in healthcare with a progressive focus on charge to payment relationship and patient account functions and understanding of health care financing and reimbursement mechanisms along with management.
  • EPIC Proficiency. 
  • Must have the ability to plan, develop, and present educational or programmatic materials in front of an audience greater than 20.
  • Strong organizational skills to keep track of multiple priorities of highly detailed information.
  • Must have the ability to make independent decisions.
  • Must have extensive knowledge of ethical and compliant business practices.
  • Must be able to handle sensitive, stressful and confidential situations and account information.
  • Strong quantitative, analytic, and problem solving skills to evaluate all aspects of a problem or opportunity and draw valid conclusions to make or facilitate appropriate and timely decisions.
  • Must have practical experience with Word, Excel, Powerpoint, and Access.

3. BA in Accounting with 7 Years of Experience

  • Experience in a large integrated health system, or related organization. 
  • Significant experience in Revenue Cycle Operations, with a proven track record in implementing new strategies in revenue cycle that result in operational efficiencies and quantitative improvements
  • Experience in a management-level capacity
  • Knowledge of various hospital and professional fee coding systems including ICD-9/10-CM, CPT and HCPCS.
  • Knowledge of the content, structure and maintenance of the Chargemaster and fee schedule
  • Outstanding directing abilities and a demonstrated track record of leadership and performance.
  • Strong executive presence, including communication skills that enable appreciation of others’ perspectives and the ability to offer compelling insights and recommendations
  • Strong quantitative, analytic, and problem-solving skills to evaluate all aspects of a problem or opportunity and draw valid conclusions to make or facilitate appropriate and timely decisions.
  • Excellent oral and written communication skills and able to communicate effectively with all levels of management
  • Experience using a wide range of HIS platforms. 
  • Experience leading a blended team environment with primary remote staff, focusing on employee engagement

4. BA in Finance with 10 Years of Experience

  • Progressive management experience in healthcare revenue cycle environment 
  • Must possess strong management skills and ability to make decisions, directing, delegating and supervising staff.
  • Excellent organizational, interpersonal and leadership skills.
  • Excellent negotiation and problem-solving skills.
  • Excellent verbal and written communication skills, ability to effectively communicate with physicians, patients, staff, payers, and executives.
  • Ability to investigate analyze and resolve issues at a high level, work efficiently and accurately and organize and plan work.
  • Ability to work effectively with individuals of all cultures and levels of authority.
  • Working knowledge of SMS/Invision
  • Experience in Business Development or Client Management Leadership
  • Knowledge of insurance regulatory and contractual requirements
  • Demonstrated ability to identify, develop and execute strategy

5. BA in Public Health with 7 Years of Experience

  • Working knowledge and experience in ICD-10, CPT and HCPCS Level II Coding
  • Knowledge, understanding and proper application of Medicaid, Medicare and third-party payer UB-04 billing and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims
  • Knowledge of current code bundling rules and regulations along with proficiency on issues regarding compliance, and reimbursement under outpatient grouping systems such as Medicare OPPS and Medicaid or Commercial Insurance EAPG's
  • Knowledge and understanding of hospital charge description master coding systems and structures
  • Excellent verbal and written communication skills due to direct interaction with senior management
  • Strong time management and organizational skills
  • Strong problem solving and financial analytical skills
  • Ability to interact professionally with all levels of employees
  • Improves technical skills through professional development efforts
  • Timeliness and accountability
  • Experience with EPIC EMR and related system functions strongly 
  • Prior experience in a large acute care hospital setting with multi-specialty physician group practice or faculty practice environment

6. BA in Information Systems with 7 Years of Experience

  • Professional certification (CPA, Coding, HFMA, Epic system or similar)
  • Previous healthcare industry experience
  • Previous work experience in patient finance, hospital or professional coding and/or revenue cycle consulting in a managerial position required, with prior experience in hospital revenue integrity 
  • Prior experience with Epic 
  • Excellent verbal and written communication skills due to direct interaction with senior management.
  • Strong time management and organizational skills.
  • Strong problem solving and financial analytical skills.
  • Ability to interact professionally with all levels of employees.
  • Improves technical skills through professional development efforts.
  • Must be comfortable educating staff members
  • Ability to handle multiple tasks with excellent problem-solving skills
  • Well organized with the ability to maintain accuracy and confidentiality

7. BA in Organizational Leadership with 10 Years of Experience

  • Healthcare experience leading revenue integrity initiatives and/or building high performing teams consisting of CDM, coding, charge capture and data management SMEs
  • CPC, RHIT, CCS, or CMC coding credentials 
  • Demonstrates understanding of business and how actions contribute to company performance
  • Demonstrates excellent customer service skills
  • Extensive clinical operations and knowledge of charge creation, processing and reconciliation in a health care environment 
  • Experience with healthcare Physician billing, payment, and compliance practices as relate to the establishment and management of charging systems and processes
  • Strong analytical background with ability to translate, communicate and present, at an executive level, clinical and coding information
  • Excellent communication skills and industry trending knowledge to facilitate physician and other stakeholders’ buy in process
  • Knowledge of EHR software systems and Microsoft Office products
  • Professional verbal and written communication skills
  • Ability to develop reports and create presentations
  • Ability to work collaboratively across disciplines and business lines.
Relevant Information
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