Revenue Integrity Coding Specialist

Job Summary

Providing revenue cycle support services, the full-time Revenue Integrity Coding Billing Specialist will efficiently review and resolve assigned Medicare and third-party payer accounts remotely, focusing on claim edits and denials.

Key responsibilities

• Resolve daily claims with Revenue Integrity pre-bill edits and specific hold codes in the hospital billing scrubber
• Review clinical documentation to validate and apply appropriate ICD-10, CPT, and HCPCS codes
• Ensure compliance with Federal/State guidelines and maintain knowledge of Medicare, Medicaid, and third-party payer billing requirements

Required qualifications

• High School Diploma (relevant experience may substitute formal education)
• 5+ years of Revenue Integrity experience
• AAPC or AHIMA coding certification
• Experience in ICD-10, CPT, and HCPCS Level II coding
• Proficiency in determining medical necessity based on provider documentation