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), ensuring compliance with coding and billing regulations while working remotely.

Key responsibilities:

• Oversee the timely synchronization of CDM data and ensure annual updates required by Medicare and other payers are completed
• Lead meetings with stakeholders to address compliance issues and improve charge capture processes
• Act as a subject matter expert for projects impacting revenue integrity and provide guidance on CDM maintenance and charge capture improvement initiatives

Required qualifications:

• Associate's Degree in Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or a related field
• Certification 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 coding, billing, and charge audit environments
• Experience with inpatient and outpatient billing requirements and knowledge of government reimbursement methodologies
• Proficient in MS Office and Windows applications