Rev Integrity Specialist - Charge Description Master

Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God’s love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.

Job Requirements:

• Coding certification CPC-Certified Professional Coder or - Certified Coding Specialist required (external candidates holding, internal candidates with relevant experience certification required 18 months)
• RHIT and RHIA preferred.
• 2–5+ years in revenue cycle (e.g. HIM, PFS/Billing, CDM), charge capture, or coding/edit resolution.
• Preferred experience coding in acute outpatient hospital setting.
• Coder, Health Information
• CCS or CPC coding certification required.
• Preferred member of AHIMA and/or AAPC Professional Associations.
• Consideration for other recognized medical coding certifications may be considered with Director approval.

Job Responsibilities:

• Knowledge of healthcare revenue cycle processes in assigned area/department
• Knowledge of regulatory and governing body coding and billing guidelines.
• Ability to navigate Epic EMR & chart auditing for supporting charge related documentation.
• Proficient in data entry using Microsoft Office Suite products.
• Possess strong interpersonal, team building, and analytical skills
• Ability to work with minimal direction
• Ability to prioritize
• Experience resolving CCI, MUE, OCE, EAPG edits.
• Proficiency in Epic or other major EHR/billing scrubbers.
• Strong analytical skills, attention to detail, and familiarity with payer billing regulations
• Review and resolve claim edits in work queues using Epic or billing scrubber systems.
• Apply coding corrections or modifiers in response to CCI, MUE, OCE, and EAPG rejections.
• Consult documentation and coding guidelines (ICD 10, CPT, HCPCS), adjust charges as required.
• Reach out to clinical teams or coders to confirm documentation and corrections.
• Track trends in edits and provide feedback or training to prevent recurring issues.
• Support revenue integrity by auditing denied or held claims and optimizing charge capture.
• Assist with charge master/CDM maintenance and updates based on trend analysis.
• Performs other duties as assigned

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