Senior Revenue Integrity Specialist – Clinical Revenue Integrity

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

📋 Description

• Provides leadership for the daily workflow of Chargemaster (CDM) maintenance across various entities of the Keck Medical Center of USC.

• Monitors the alignment of different entities with standard policies for maintaining the CDM.

• Ensures that the Chargemaster (CDM) complies with all coding and billing regulations while accurately reflecting the services rendered.

• Conducts meetings to assess departmental charge processes aimed at enhancing charge capture and coding compliance.

• Collaborates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics, and Integration teams on technology initiatives that affect charge entry, charge dictionaries, and charging processes.

• Provides data from multiple entities of Keck Medical Center of USC to support critical decision-making and functions related to the Chargemaster, CDM maintenance, and enhancement of charge capture.

• Serves as a subject matter expert in compliance and service pricing.

⛳️ Requirements

• Required: Associate’s Degree in Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or a related field.

• Required: Specialized technical training certification from an accredited program in Certified Coding (CPC/CCS/COC) or Certified Professional Medical Auditor (CPMA) within one year of the hire date.

• Required: Minimum of 5 years of experience in the healthcare sector.

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

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

• Required: Ability to adopt a systematic, self-motivated approach to problem-solving and effectively identify, coordinate, and optimize resources to execute plans.

• Required: Proficient in MS Office and Windows.

🏝️ Benefits

• Excellent benefits and perks.

• Opportunity to work in a dynamic and diverse environment.

• Competitive salary.

• Work in careers that encompass a wide range of talents and skills.