Revenue Integrity Coding Billing Supervisor

Guidehouse

. Investigate, track and resolve health care claim billing errors and denials .

Posted 9/22/2026full-timeRemote • United StatesMid-LevelSenior💰 $61,000 - $101,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare claim billing, including ICD-10, CPT, and HCPCS coding, while ensuring compliance with Medicare, Medicaid, and third-party payer requirements. Proven ability to manage teams, resolve billing errors, and improve revenue integrity processes.

Highest-signal resume keywords

ICD-10 CodingCPT CodingHCPCS Level II CodingAAPC CertificationRevenue Integrity Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Necessity DeterminationClaim Denial ResolutionBilling ComplianceUB-04 BillingCode Bundling RulesOutpatient Grouping SystemsHospital Charge Description Master KnowledgeRevenue Integrity KPIsClinical Documentation ReviewStaff Supervision

Soft Skills

Strong Verbal CommunicationWritten CommunicationInterpersonal SkillsTeam CollaborationTraining and Development

Tools & Technologies

Guidehouse METRIX SystemWordExcel

Certifications & Qualifications

AAPC Coding CertificationAHIMA Coding Certification

Industry Keywords

Healthcare BillingRevenue Integrity ProgramMedicare ComplianceMedicaid ComplianceThird-Party Payer Requirements

About the role

Key responsibilities & impact

Investigate, track and resolve health care claim billing errors and denials
Support the Revenue Integrity Program and improve compliance with government, managed care and third-party payer billing and reporting requirements
Collaborate with CRCM project team and client stakeholders on continuous process improvements and Revenue Integrity KPIs
Review and resolve assigned Medicare and third-party payer accounts subject to pre-bill claim edits, hospital billing scrubber hold edits and claim denials
Resolve CCI, MUE, Medical Necessity and other claim-level billing edits
Review clinical documentation and diagnostic results to validate and apply ICD-10, CPT, HCPCS codes and coding modifiers
Resolve Revenue Integrity-specific denials in the Guidehouse METRIX system
Ensure coding and billing practices comply with Federal/State guidelines
Maintain current knowledge of Medicare, Medicaid and third-party payer billing compliance requirements
Collaborate with departments and professionals to resolve revenue integrity issues
Supervise and train RI staff to ensure appropriate reimbursement and compliance
Develop and maintain client policies and procedures
Act as liaison between RI teams and client, communicating expectations clearly
Review new RI team members’ work for compliance and quality before release
Monitor staff productivity, workload and workflows to meet turnaround standards
Determine staffing needs and adjust schedules
Complete employee timesheets and time-off entries in the payroll system
Assist with interviewing and hiring qualified RI staff
Participate in monthly client and RI team conference calls
Provide daily support to resolve facility-related problems and questions
Evaluate team member competency and provide ongoing training and development

Requirements

What you’ll need

University degree or equivalent of 5 years job related experience
Must have three years management experience
AAPC or AHIMA coding certification required
Experience in ICD-10, CPT and HCPCS Level II Coding
Expertise in determining medical necessity of services provided and charged based on provider/clinical documentation
Knowledge, understanding and proper application of Medicare, Medicaid, and third-party payer UB-04 billing and reporting requirements
Experience resolving CCI, MUE and Medical Necessity edits applied to claims
Proficiency in determining accurate medical codes for diagnoses, procedures and services performed in the outpatient setting
Knowledge of current code bundling rules and regulations
Proficiency on 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
Strong verbal, written and interpersonal communication skills
Word/Excel proficient
Ability to produce accurate assigned work product within specified time frames
Hospital medical billing and auditing experience preferred
Travel required up to 10%
No security clearance required

Benefits

Comp & perks

Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program
Flexible benefits package