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Revenue Integrity Manager, CDM Operations
The Wilshire GroupRevenue Integrity & CDM Operations Manager leading Charge Description Master strategy at The Wilshire Group. Focusing on compliance initiatives and collaboration across various teams to enhance revenue cycles.
About the role
Key responsibilities & impact- 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
Requirements
What you’ll need- 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
Comp & perks- 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
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Charge Description Master (CDM)CPTHCPCSICD-10revenue integrityhospital billinghealthcare reimbursementbilling discrepanciescompliance monitoringpricing reviews
Soft Skills
analytical skillsorganizational skillsproblem-solving skillsprocess improvementstrategic oversightguidancecollaborationmulti-taskingleadershipcommunication
Certifications
Bachelor’s degree in Healthcare AdministrationBachelor’s degree in Health Information ManagementBachelor’s degree in Finance