California Licensed Revenue Integrity Specialist

Job Summary

Providing leadership in clinical charge capture, the full-time California Licensed Revenue Integrity Specialist will manage the maintenance of the Charge Description Master (CDM), ensure compliance with coding and billing regulations, and coordinate with various departments to enhance charge capture processes in a fully remote environment.

Key responsibilities:

• Oversees the timely and accurate synchronization of CDM data and conducts annual updates required by Medicare and third-party payers
• Leads meetings with stakeholders to address compliance issues and improve charge capture and coding processes
• Acts as a subject matter expert for revenue integrity projects and provides guidance on CDM maintenance and charge capture improvements

Required qualifications:

• Associate's Degree in Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or a related field
• Certification from an accredited program as a Certified Coder (CPC/CCS/COC) or Certified Auditor (CPMA) within one year of hire
• Five years of experience in the healthcare field, including clinical service delivery, coding, and charge audit environments
• Experience with inpatient and outpatient billing requirements and CMS Medicare reimbursement methodology
• Proficient in MS Office and Windows applications