Hospital Revenue Integrity Specialist

Overview Join Our Team at Oklahoma Heart Hospital (OHH) ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients' journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we are shaping the future of heart care in Oklahoma by serving the state and leading the nation. Benefits Why You’ll Love Working Here: Comprehensive Benefits: Medical, Dental, and Vision coverage 401(k) plan with employer match Long‑term and short‑term disability Employee Assistance Programs (EAP) Paid Time Off (PTO) Extended Medical Benefits (EMB) Opportunities for continuing education and professional growth Responsibilities The Hospital Revenue Integrity Specialist is responsible for evaluating charges for hospital claims against clinical documentation to identify missing, incorrect, or late charges. They evaluate charge capture processes to comply with government and non‑government rules and regulations, work pre‑bill edits related to clinical documentation (including CCI edits, MUEs, and billing edits), facilitate a charge reconciliation program with clinical leadership, and provide communication on missing or incorrect charges, making recommendations on best practices. Review all system and clearing house edits for potentially missing or incorrect charges or modifiers. Utilize EMR and clearinghouse to manage claim edits to preserve revenue and ensure all charges are added correctly based on clinical documentation. Validate claims data against payer rules and regulations, and provide clean claims within five days from discharge. Provide root cause analysis and feedback on incorrect charging practices and consult and collaborate with adjacent departments to proactively prevent revenue leakage. Assist physicians in placing the correct procedure code for procedures when ordering or rendering services. Recommend system optimization to capture frequently missed or incorrect charges. Qualifications Education : High school graduate or equivalent preferred. Experience : Minimum of two (2) years in Revenue Integrity, coding, charge entry, or billing (hospital setting preferred). Knowledge of CPT/HCPCS and ICD-10 coding. Cardiology experience is a plus. AHIMA or AAPC certification is preferred. As part of our team, you are empowered to work collaboratively with our physicians and other caregivers, and play an integral role in setting the standard for excellence in patient care. Every team member at OHH plays an integral role in our patients' experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care. #J-18808-Ljbffr Oklahoma Heart Hospital