Revenue Integrity Specialist

Revenue Integrity Specialist

Seeking experienced clinical professionals to support revenue integrity projects, documentation review, charge capture accuracy, and audit activities across multiple service lines. This role acts as the subject matter expert for charge capture, CDM management, and revenue cycle assessments.

Top responsibilities include:

• Leading charge capture improvement initiatives and reconciliation.
• Managing CDM updates, charge audits, and documentation review.
• Conducting full revenue cycle assessments (registration → reimbursement).
• Performing chart/bill audits and communicating findings to leadership.
• Supporting Revenue Analytics, Internal Audit, Billing Compliance, and PFS.
• Preparing reports and presenting findings to clinical and administrative teams.

Required qualifications include:

• Bachelor's degree in a clinical field (Required)
• Registered Nurse (RN) – PA license required upon hire
• Minimum 5 years clinical experience (RN/APN/clinical specialist)
• Experience with billing & documentation systems
• Working knowledge of coding rules (or willingness to obtain within 3 months)

Preferred:

• Master's degree
• CPC certification (AAPC)
• Pediatric clinical experience
• Audit or project management experience

Key skills include:

• Charge capture, billing, coding, documentation review
• Revenue cycle knowledge
• Strong analytical & organizational skills
• Excellent written & verbal communication
• Project management
• Proficiency in Word, Excel, PowerPoint, Visio