Revenue Integrity Specialist

Job description

Job Summary: Responsible for complete and accurate charge capture through review of medical record documentation of clinical services and procedures to ensure data integrity. Performs charge reconciliation activity to ensure optimal charge capture in accordance with Medicare, Medicaid or Third Party payor guidelines. Classification systems include ICD-9-CM, CPT, HCPCS as well as other specialty financial systems required for charging, billing and reimbursement analysis. The Revenue Integrity Specialist may be a resource to coding, reimbursement, and departmental areas for questions related to charges, auditing and the charge master. Duties and Responsibilities: Review medical records to identify clinical services and procedures eligible for revenue capture and charge scrubbing. Ensures all documented, eligible clinical services and procedures are available for selection in the charge master and initiates and tracks charge intervention forms. Interacts with physicians to clarify and accurately document patient diagnostic and procedural information as charged. Enters charge information into the computerized databases. Ensures timely record availability by meeting established bill hol...