Senior Revenue Integrity Specialist – Clinical Revenue Integrity

This is a fully remote position, open to applicants in California.

📋 Description

• Lead the daily operations of the CDM maintenance workflow.

• Oversee the alignment of different entities with established policies for managing the CDM.

• Guarantee the timely and precise synchronization of data between the CDM and management tools.

• Organize meetings to assess the department's charge processes for enhancing charge capture and coding compliance.

• Collaborate with various departments on technology initiatives affecting charge entry.

• Provide data for management to support critical decisions related to the Chargemaster and CDM Maintenance.

• Address inquiries concerning Chargemaster issues and oversee educational initiatives for clinical revenue-generating staff.

• Work closely with revenue auditors to research and resolve requests.

• Maintain the Charge Description Master for the Keck Medical Center of USC.

⛳️ Requirements

• An 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 a Certificate of Auditing (CPMA) within one year from the hire date.

• A minimum of 5 years of experience in the healthcare sector.

• Familiarity with inpatient and outpatient billing requirements (UB-04) and CMS Medicare reimbursement methodologies.

• Knowledge of government and third-party payer reimbursement methodologies.

• Proficient in MS Office/Windows skills and knowledge.

🏝️ Benefits

• Health insurance.

• 401(k).

• Flexible working hours.

• Paid time off.

• Professional development opportunities.

• Reasonable accommodations for applicants and employees with disabilities.