Revenue Integrity Billing & Compliance Manager
JAMEELAH N. GORDEN
Johns Hopkins Healthcare
13
years of professional experience
1
Certification
Healthcare revenue cycle leader with 20+ years of experience in billing optimization and Epic systems. Expertise in charge capture, payer compliance, and managing cross-functional programs to enhance financial performance. Demonstrated success in data analysis and executing complex billing system updates in hospital and multi-specialty settings. Certified Professional Coder (CPC, CPC-I) with strong skills in Epic configuration and revenue recovery initiatives.
Work History
Revenue Integrity Billing & Compliance Manager
2 Years 8 Months- Lead revenue integrity, charge capture, and billing compliance for Laboratory & Pathology.
- Maintain CDM accuracy and compliance, including annual updates, pricing, and denial remediation.
- Train and support clinical, billing, and administrative teams to optimize compliance and revenue.
- Serve as compliance liaison to department leadership and corporate compliance.
- Manage Epic system edits and rebilling projects to recapture lost revenue.
- Track metrics and identify trends for continuous improvement.
- Developed compliance policies to ensure regulatory adherence across healthcare operations.
- Conducted regular audits to identify compliance gaps and recommend corrective actions.
- Monitored changes in regulations and updated policies accordingly for all staff.
- Prepared compliance reports for senior management and regulatory agencies as required.
- Provided support in developing strategies for mitigating risks associated with non-compliance.
- Ensured effective communication of changes in regulations or policies throughout the organization.
- Facilitated meetings between stakeholders, including executive leadership, legal counsel, and department heads, to discuss compliance matters.
- Identified processes and policy gaps and devised solutions for and requirements.
Sr. Business Consultant / Principal Trainer – Revenue Cycle Operations
4 Years 2 Months- Played an integral role in over 10 Epic EMR implementations and billing go-lives for newly launched and acquired hospital facilities, ensuring alignment across charge capture, billing workflows, and training protocols.
- Lead billing optimization initiatives with hospital CFOs to improve net revenue, denial rates, and DNFB.
- Oversee Epic system changes for billing workflows, including charge router setup, department builds, and billing pathways.
- Design, test, and implement Epic workqueue rules and claim edits in alignment with payer guidelines.
- Manage financial and operational impact of department changes (additions, relocations, consolidations) within Epic.
- Use Epic Radar, RWB, and SlicerDicer to track KPIs, perform root cause analysis, and develop improvement plans.
- Collaborate across clinical, IT, and revenue cycle teams to align operations and streamline charge capture.
- Develop and deliver Epic training programs for new hires and optimization efforts.
- Participate in Epic EMR implementations and upgrades, providing go-live support and post-deployment optimization.
- Conduct workflow process analysis and training environment updates to enhance revenue cycle performance.
- Create training materials, job aids, and SOPs to support billing compliance and efficiency.
- Led strategic planning sessions to enhance operational efficiency across departments.
- Facilitated cross-functional workshops to align business objectives with healthcare initiatives.
- Developed training programs to enhance staff competencies and service delivery standards.
- Collaborated with senior leadership to shape organizational policies and procedures.
- Conducted stakeholder interviews to gather insights for project development and implementation.
- Managed project timelines and resources to ensure timely completion of deliverables.
- Provided expert guidance on compliance regulations impacting healthcare operations and strategies.
- Performed analysis of data and presented findings and practical advice to clients.
Revenue Integrity Analyst
2 Years 8 Months- Monitored evaluation and management, emergency department, radiology, cardiology, and lab charges using Epic.
- Conducted medical documentation abstraction to ensure accurate CPT, ICD-10-CM, and HCPCS code assignment.
- Partnered with CDM team for annual updates, issue identification, and testing of new charges.
- Educated clinical managers and staff on billing and coding regulations to reduce denials and increase compliance.
- Tracked trends and created policies and training materials to improve charge capture.
- Collaborated with process owners to implement and test remediation plans for revenue integrity.
Revenue Integrity Analyst
2 Years 3 Months- Collaborated with A/R, Coding, and front-end teams to reduce denials and improve reimbursement.
- Conducted data analysis to identify trends and developed strategies for billing improvement.
- Partnered with Radiology Billing leadership to operationalize policy and process changes.
Coding Compliance Manager
1 Year 4 Months- Performed audits, trained providers and billing teams, and led documentation improvement initiatives.
- Oversaw staff scheduling, training, and education delivery across a team of 50.
Education
Master of Business Administration - Healthcare Administration
Skills
Epic systems expertise
Revenue cycle optimization
Charge capture strategies
Stakeholder engagement
Data analysis
Process improvement
Cross-functional collaboration
Project management
Internal audits
Document reviews
Staff training
Workqueue management
Claims analysis and denials
Reporting and KPI development
Revenue integrity strategies
Project coordination
Payer policy adherence
Staff training and leadership
Certification
- Epic - Resolute Professional Billing (Admin & Curriculum)
- Certified Professional Coder (CPC), AAPC
- Certified Professional Coding Instructor (CPC-I), AAPC
Timeline
Revenue Integrity Billing & Compliance Manager
Johns Hopkins Healthcare
03.2024 - CurrentRead More
Sr. Business Consultant / Principal Trainer – Revenue Cycle Operations
Piedmont Healthcare
01.2021 - 03.2025Read More
Revenue Integrity Analyst
Piedmont Healthcare
05.2018 - 01.2021Read More
Revenue Integrity Analyst
NYU Langone Medical Center
10.2015 - 01.2018Read More
Coding Compliance Manager
MedTech Professional Billing
05.2014 - 09.2015Read More
Walden University
Master of Business Administration from Healthcare Administration
Read More