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Physical Rehabilitation Network (PRN) · 9 hours ago

Data Intergrity Manager

United States

Full-time

Remote

Mid, Senior Level

4+ years exp

Physical Rehabilitation Network (PRN) is seeking a Data Integrity Manager to oversee and direct their operations, ensuring optimal cash flow and high-quality billing performance. The role requires strong leadership and expertise in revenue cycle management, with responsibilities including managing billing processes, analyzing operational data, and ensuring compliance with regulations.

Health CareMedical DeviceRehabilitationTherapeuticsWellness

Growth Opportunities

Responsibilities

Leads and manages all operations within the Data Integrity department

Serves as the organization’s subject matter expert and primary resource for all Raintree system needs

Reviews and analyzes billing and claims for accuracy and completeness; submits claims to appropriate payers and resolves submission issues

Compiles, validates, and distributes accurate statistical and operational reports

Oversees ServiceOne tickets, providing Raintree support and managing payer portal requests

Manages clearinghouse activities, including claims and remit enrollment

Oversees EFT and ERA enrollment processes

Configures and maintains HCFA and A837P claim setups

Supports onboarding of new partnerships and ensures accurate integration into Raintree

Maintains and updates all Raintree system tables

Conducts audits of current billing procedures to improve efficiency and accuracy

Ensures billing operations comply with Federal, State, and payer regulations, guidelines, and internal protocols

Contributes to the development, implementation, and refinement of operating policies and procedures

Analyzes operational data to identify opportunities for process improvements and system enhancements

Monitors trends impacting claims performance and adjusts staffing, workflows, and policies as needed

Stays current on carrier rule changes and communicates updates to relevant teams

Maintains up-to-date knowledge of coding, billing regulations, and compliance requirements

Maintains working knowledge of health information management standards, including HIPAA and related regulations

Supervises Data Integrity staff, including workload allocation, training, performance evaluation, and problem resolution

Coordinates and delivers training for new and existing staff on systems, protocols, and operational standards

Manages team scheduling to ensure adequate coverage and continuity of daily operations

Performs additional related duties as assigned

Qualification

Raintree system expertiseRevenue cycle operationsMedical billing knowledgeCPT/HCPCS/ICD-10 codingMicrosoft Office proficiencyData analysis skillsLeadership abilitiesInterpersonal skillsProblem-solving skillsCommunication skills

Required

4–6 years of revenue cycle experience in a healthcare environment; Physical Rehab experience preferred

High school diploma or GED required

Bachelor's degree in accounting, business, or equivalent experience required

Comprehensive understanding of medical billing, collections, payment posting, revenue cycle operations, and Medicare/third-party payer requirements

Working knowledge of CPT, HCPCS, ICD-9/ICD-10 coding, CMS-1500 and UB-04 claim forms, HIPAA, insurance regulations, medical terminology, and appeals processes

Strong grasp of business management and basic accounting principles

Ability to interpret and apply organizational policies and procedures

Familiarity with current health information technologies and applications

Strong interpersonal skills with the ability to build effective working relationships across teams and with external partners

Skilled in developing, implementing, and optimizing work processes

Proficiency in Microsoft Office (Outlook, Word, Excel)

High attention to detail and ability to manage frequent interruptions

Working knowledge of Raintree and Waystar systems

Ability to work independently with strong initiative

Strong supervisory and training abilities, including prioritizing and scheduling work to meet deadlines

Strong problem-solving skills with the ability to manage complex variables

Ability to make sound, independent decisions related to A/R, billing, and operational needs

Ability to identify, evaluate, and correct errors and streamline processes

Ability to conceptualize workflows, develop plans, and execute improvements

Excellent written, verbal, and interpersonal communication skills

Preferred

Project management experience preferred

Experience with healthcare account reconciliations and reimbursement methodologies

Experience with data extraction, analysis, and decision support tools

Strong understanding of revenue cycle functions including billing, collections, denials, and bad debt

Demonstrated leadership in team environments, special projects, and complex assignments

Experience with Raintree preferred

Experience with Waystar and Jopari preferred

Experience with system implementations or system conversions preferred

Company

Physical Rehabilitation Network (PRN)

Physical Rehabilitation Network (PRN) was founded in 1991 to assist physical therapists in developing and operating their own practice without carrying the burden of business administration and back office functions.

Founded in 1991

Carlsbad, California, USA

1001-5000 employees