Director, Revenue Integrity & Professional Billing Clinical Documentation Integrity (CDI)

Position Description:

The Director of Revenue Integrity & Professional Billing CDI is a strategic leader responsible for optimizing clinical documentation, professional billing accuracy, and revenue cycle performance. This role oversees CDI efforts to assure Denials Prevention, Clinical Documentation Improvement, Provider Education, and Professional Services Auditing. The Director will lead initiatives to reduce denials, enhance charge capture, and ensure compliance with payer and regulatory requirements. This position requires strong leadership, analytical acumen, and the ability to collaborate across departments to drive documentation excellence and revenue integrity. 

Responsibilities:

• Leadership & Team Oversight
• Lead and mentor teams including RNs, coders, documentation specialists, and managers across Denials Prevention, CDI, Provider Education, and Auditing.
• Foster a culture of accountability, collaboration, and continuous improvement.
• Conduct performance evaluations and support professional development.
• Program & Operational Management.
• Oversee daily operations of CDI program.
• Ensure alignment with organizational goals, compliance standards, and payer requirements.
• Develop and implement strategies, policies, and procedures to improve revenue cycle performance.
• Documentation Optimization & Provider Education.
• Optimize Epic clinical documentation templates and functionality for accurate charge capture.
• Develop specialty-specific education programs to improve documentation, coding and billing accuracy.
• Ensure adherence to industry regulations, coding guidelines, and reimbursement methodologies.
• Serve as a subject matter expert related to clinical documentation and provide education and training as needed.
• Analytics & Strategic Initiatives: Utilize data analytics to identify trends, monitor KPIs, and drive performance improvements.
• Develop dashboards and reports to communicate program impact and opportunities.
• Lead cross-functional meetings and present outcomes to senior leadership.
• Stakeholder Engagement: Collaborate with compliance, coding, clinical, and revenue cycle leadership.
• Serve as liaison between providers, coders, and operational teams. 

Knowledge – Skills – Abilities: 

• Strong leadership and persuasive communication skills.
• Proficiency in clinical and financial data analysis.
• Expertise in Epic documentation, coding, and charge capture workflows.
• Advanced skills in Excel, Tableau, Power BI, or similar tools.
• Deep understanding of CPT, ICD-10, professional claims processing, and payer behavior.
• Ability to manage multiple priorities in a fast-paced environment.

Preferred Schedule:
Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs.

Position Requirements:

Minimum Qualifications:
Appropriate experience may be substituted for education on an equivalent basis
Minimum Required Education:            Bachelor’s degree in business, healthcare, nursing or related field.
Minimum Required Experience:           Six (6) years of leading teams in revenue cycle operations.
Required Certification/Licensure(s):   Certified professional coder (CPC, CPC-A, CCS-P, or CCA) and/or health information management credential (RHIT or RHIA) and/or Clinical Documentation Improvement Specialist (CDIP or CCDS) is required.

Preferred Qualifications:
Preferred Education:                            Master’s degree in Business Administration, Healthcare Administration, Nursing, Health Information Management, or related discipline.
Preferred Experience:                          Eight+ (8+) years of progressive responsibility in healthcare administration regarding revenue cycle operations.
Preferred Certification/Licensure(s):  Certified Professional Medical Auditor (CPMA) is preferred. Nursing degree (RN) is strongly encouraged.

#LI-RT1 

Why MCW?

• Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
• 403B Retirement Package
• Competitive Vacation and Paid Holidays offered
• Tuition Reimbursement
• Paid Parental Leave
• Pet Insurance
• On campus Fitness Facility, offering onsite classes.
• Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc. 

For a full list of positions see: www.mcw.edu/careers  

For a brief overview of our benefits see: https://www.mcw.edu/departments/human-resources/benefits

MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination
The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering an inclusive community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants, or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.

.