Revenue Integrity Supervisor - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ

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Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region. Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates. The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time). Pay Range: $38.63 - $50.46 Scheduled Weekly Hours: 40 Position Overview Leads daily operations of Revenue Integrity work queues and staff, ensuring accurate, compliant, and timely pre-bill claim readiness across hospital and ambulatory services. Responsible for frontline execution, quality control, escalation management, and team coaching across charge integrity, authorization integrity, surgical implant/device reconciliation, and CDM support workflows. Ensures high-risk accounts are identified and corrected prior to billing, with specific operational oversight of pre-bill charge verification, authorization validation pre-service and post-procedure pre-bill to ensure the authorization aligns with procedures actually performed. Partners closely with clinical departments, central scheduling, pharmacy, patient financial services, and informatics to resolve upstream defects and prevent revenue leakage. MINIMUM REQUIREMENTS Education: Associate degree in Nursing, Health Information, Healthcare Administration, Business, or related field required. Bachelor's degree preferred. Experience: Four years' progressively responsible experience in hospital revenue cycle, revenue integrity, patient financial services, or related function required. One year' lead/supervisory experience preferred. Demonstrated experience with pre-bill charge review, authorization workflows, and account-level correction processes required. Experience with procedural areas (OR, Cath Lab, IR, imaging, cardiology, etc.) preferred. Other Credentials: Knowledge and Skills: Strong knowledge of hospital charge capture, CPT/HCPCS/revenue code usage, and claim workflow dependencies. Strong understanding of payer authorization requirements and procedure/auth alignment risks. Strong analytical, organizational, and follow-through skills with the ability to manage high-volume, time-sensitive work queues. Strong communication and conflict-resolution skills across clinical, operational, and physician office stakeholders. Ability to coach staff, enforce standards, and drive accountability. Special Training: Proficiency in EHR and revenue cycle systems, work queues, and account review tools. Strong Excel and reporting/dashboard proficiency. Ability to document trends, root causes, and corrective action plans. Mental, Behavioral and Emotional Abilities: Ability to function with minimal supervision and exercise sound judgment. Ability to collect, create and research complex or diverse information Usual Work Day: 8 Hours Reporting Relationships Does this position formally supervise employees? Yes If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager. ESSENTIAL FUNCTIONS Supervises day-to-day Revenue Integrity operations and staff performance across assigned work queues. Assigns, prioritizes, and monitors work based on risk, filing timeliness, and financial exposure. Oversees pre-bill charge integrity review, including missing/incorrect CPT, HCPCS, revenue code, and unit corrections. Oversees authorization integrity workflows including: pre-service verification that required authorizations are present and accurate, and post-procedure pre-bill validation that approved authorization(s) match procedures actually performed (CPTs, units, setting, dates, site of service). Oversees surgical/procedural revenue integrity controls, including implant/drug/device reconciliation, invoice availability checks, and hold/release management for unresolved high-risk accounts. Coordinates daily escalation management with Central Scheduling, procedural departments, physician offices, pharmacy, and billing to resolve issues before claim finalization. Enforces standard documentation requirements for account notes, issue categorization, action tracking, and closure rationale. Performs quality audits of teamwork, provides feedback, and drives corrective action for performance and process