Charge Integrity Specialist - Revenue Integrity

Overview Under the direction of the Manager of Revenue Integrity, the Charge Integrity Specialist reviews and validates patient charges before billing to ensure accuracy and compliance with coding and billing regulations. The role involves collaborating to resolve discrepancies, improve the charge capture process, identify trends and themes, and ensure all charges are accurately reflected in patient accounts. Any issues are promptly addressed, and the position receives general oversight from the Charge Review Coordinator. General Duties Review patient charges to validate they are accurately entered and supported by clinical documentation. Ensure charges match the procedures and services provided using appropriate charge capture standards. Assist in the daily resolution of revenue integrity edits that prevent accounts from billing by reviewing the medical record and applicable documentation. Identify and investigate discrepancies or missing charges in patient accounts, report issues, and participate in resolution of potential or actual revenue/charge related issues. Coordinate Charge Description Master (CDM) error findings with the CDM team. Monitor EPIC Revenue Integrity Dashboard(s) and RI assigned work queues to assist in completion and timeliness of tasks meeting Revenue Integrity Department standards. Respond to departmental charging inquiries in a timely manner and document questions received to create a repository. Provide support for assigned cost centers within service lines in collaboration with the charge integrity teammates. Work with Coding and other clinical departments to identify and resolve errors based on ICD/CPT Coding Guidelines and National Correct Coding Initiative edits. Contribute to and support quarterly improvement initiatives directed by revenue integrity leadership. Serve as the primary service line representative for all charge-related inquiries, issues, and proper usage of charge codes. Offer feedback on identified issues and potential solutions in the spirit of process improvement. Monitor and report charge capture trends and provide input on improvements that prevent revenue leakage. Perform quality work within deadlines and/or Key Performance Indicators (KPIs) with or without direct supervision. Interact professionally with coworkers and customers. Work effectively as a team contributor on all assignments. Work independently while communicating and coordinating work efforts with other employees and organizations. Deliver a positive patient experience where applicable. Complete and/or attend mandatory training and education sessions within approved organizational guidelines and timeframes. Perform other miscellaneous duties as assigned. Experience Qualifications Required: 2 years' experience in a hospital setting, revenue cycle, healthcare industry, or coding. Preferred: EPIC HB/PB experience. Education Qualifications Minimum: High school diploma or GED with an equivalent combination of certification and experience. Preferred: Associate’s degree in healthcare administration, Health Information, or a related field. Licenses And Certifications Preferred certifications through AHIMA (CCA) or AAPC (CPC‑A, COC‑A). Must obtain professional credential within 6 months of employment, or Epic Certified. Skills And Abilities Interpersonal and communication skills, analytic and organizational skills, critical thinking, and the ability to meet deadlines. Computer skills: MS Office (Word, PowerPoint, Excel, Outlook), Windows operating system, and Internet. Work Shift Days (United States of America) Equal Opportunity Statement LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law. The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary. #J-18808-Ljbffr LCMC Health