Revenue Integrity Supervisor

Location: 1337 Basswood Road, Schaumburg, IL 60173 (On-site)

Reports to: Executive Manager

Direct Revenue Responsibility: $12 million annually Prism Health Care Services, based in Schaumburg, Illinois, is an ACHC-accredited, mid-sized provider of Durable Medical Equipment (DME), specializing in respiratory, enteral, medical, and related supplies. With $22 million in annual revenue, we serve over 7,500 clients across home care and skilled nursing facilities in 14 northern Illinois counties, including Cook, DuPage, Kane, Lake, McHenry, and Will. Our team of 68 professionals includes Respiratory Therapists, Registered Dietitians, Customer Service and Billing Specialists, Distribution Technicians, and Warehouse staff. We work closely with referral partners such as Alden Network post-acute discharges, hospitals, sleep centers, and physician offices, supporting both skilled nursing and home care settings as a trusted Part B provider. The Revenue Integrity Manager is a key leadership role responsible for optimizing customer service and billing operations within our DME division. This position will oversee subcontracted billing partnerships, lead internal teams, and ensure compliance with payer guidelines and regulatory standards (Medicare, Medicaid, HIPAA). The Manager will drive strategic initiatives to improve billing accuracy, operational efficiency, and client satisfaction. Success in this role requires close collaboration with inventory, logistics, and payer teams to align billing with product tracking, proactively manage claims, and minimize denials or revenue loss. We are seeking a driven professional with prior supervisory experience-preferably in healthcare or DME-who can lead with accountability, support continuous improvement, and contribute to cross-functional alignment. Candidates with a strong understanding of DME billing standards are preferred, though we are open to training high-potential individuals committed to learning and growing within the role.Key Responsibilities and Essential Job Functions:1. Operational Leadership & Optimizationa. Direct and improve the customer service and billing functions to enhance efficiency, accuracy, and patient satisfaction.b. Analyze performance metrics to identify trends and implement process improvements.2. Team Management & Developmenta. Oversee and mentor customer service and billing teams; conduct training and performance evaluations.b. Foster a culture of accountability, excellence, and continuous improvement.3. Vendor Oversighta. Manage the subcontracted billing service provider, ensuring adherence to contract terms and performance standards.b. Serve as liaison for issue resolution and continuous improvement.4. Compliance & Quality Assurancea. Ensure adherence to Medicare, Medicaid, HIPAA, OSHA, and internal policies.b. Conduct regular audits to maintain documentation integrity and process accuracy.5. Billing & Revenue Integritya. Collaborate with inventory and logistics to align billing with product tracking and order fulfillment.b. Prevent claim denials by ensuring proper documentation, policy alignment, and proactive claim management.6. Eligibility & Authorization Managementa. Oversee patient eligibility verification and authorization workflows to avoid service disruptions and reimbursement delays.7. Customer Experience Enhancementa. Refine service protocols to enhance client satisfaction and minimize escalations.b. Implement technology solutions and feedback systems to streamline communication and resolution.8. Payer & Regulatory Relationship Managementa. Maintain strong payer relationships, advocate for timely reimbursements, and resolve claim disputes.b. Ensure processes align with payer guidelines to reduce risk of TPE audits or recoupments.9. Strategic Contributionsa. Participate in company-wide projects, cross-departmental initiatives, and policy development.b. Contribute to standardizing SOPs, training resources, and process workflows across teams. Qualifications: o 3-5 years in healthcare billing or customer service management, preferably in DME or a similar setting. o Experience managing outsourced vendor relationships. o Strong understanding of DME billing, payer policies, and healthcare regulations. o Experience reducing denials and improving reimbursement cycles. o Proven ability to lead and develop high-performing teams. o Experience conducting performance reviews and managing team KPIs. o Proficient in analyzing billing and service metrics to drive decisions. o Experience with Excel, dashboards, or reporting tools. o Strong interpersonal and written communication skills. o Experience interacting with payers, vendors, and internal stakeholders. o Familiarity with Brightree or similar billing platforms. o CRM or ERP experience preferred. o Bachelor's degree in Healthcare Administration, Business, Finance, or related field preferred. o Equivalent professional experience will be considered. Responsibilities o Hire, train, and evaluate staff in accordance with company standards. o Ensure department alignment with OSHA, HIPAA, and payer-specific rules. o Monitor team productivity and ensure KPI achievement. o Assist with the development of training materials and SOPs. o Travel as needed to support business needs; valid IL driver's license required. ADA Checklist for Physical Activities and Requirements, Visual and Hearing Acuity, and Working Conditions: o Sedentary work - Sitting most of the time at workstation. Occasionally move about the office to access office machinery, file cabinets, or attend meetings. o Other movement - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. fingers rather than with the whole hand as in handling. Operates a computer and other office productivity equipment, such as a desk telephone, cellphone, copy machine, tablet, or computer printer. the spoken word. Those activities in which they must convey detailed or important spoken instructions to co-workers or customers accurately, loudly, or quickly. as preparing and analyzing data and figures or viewing a computer terminal. Visual inspection involving small defects, small parts, and/or operation of machines (including inspection), using measurement devices, and /or assembly at distances close to the eyes. speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations sound. environmental conditions; tasks are completed in an indoor, office environment. Demands - The role requires continuous use of comprehension, reasoning, decision-making, and math skills, with these tasks occurring more than 75% of the time. Demands - The role requires continuous use of seeing, hearing, speaking, and finger dexterity, with these activities occurring more than 75% of the time.