Revenue Integrity Clinical Charge Auditor

Revenue Integrity Clinical Charge Auditor – Full-Time, Days

• Revenue Integrity supports 29 hospitals and approximately 1,300 providers
• Collaborative and interactive remote team

• Associate's Degree with 7 years’ relevant experience in lieu of Bachelor's Degree (required) Or
• Bachelor's Degree with 5 years’ relevant experience (required)
• 5 years Revenue Integrity, Charge Capture, Auditing, Coding, Compliance, or Revenue Cycle experience with knowledge of Procedural-Based Service Lines (required)
• 1 Year Epic EMR (preferred)
• RN
  - Registered Nurse Upon Hire (required) Or
• ARRT
  - American Registry of Radiologic Technologists Upon Hire (required) Or
• CPC
  - Certified Professional Coder Upon Hire (required) Or
• RHIT
  - Registered Health Information Technician Upon Hire (required) Or
• RHIA
  - Registered Health Information Administrator Upon Hire (required)
• Local Candidates (highly preferred).
• Ability to interpret clinical documentation and determine appropriate charges for a patient account.
• Requires knowledge of documentation requirements and charge capture workflows, as well as working knowledge of laws and regulations pertaining to healthcare charge capture, billing, CDM/coding compliance, and revenue cycle functions.
• Demonstrate intrapersonal skills, a positive demeanor, professional skills/approach, good verbal and written communication skills, as well as initiative and self-motivation.
• Must be detail oriented and have analytical and critical thinking skills to resolve charge and revenue related issues.
• Possess ability to work independently, proactively with limited supervision and as a team player when called upon.
• Also requires ability to manage, organize, prioritize, multi-task, and adapt to changing priorities.
• MS Office including Word, PowerPoint, Excel, and Outlook.

• Accurately post charges for assigned clinical service lines based on review of clinical documentation, physician orders, results, and other charge source inputs.
• Perform charge reconciliation activities to identify and correct missing, duplicate, or inaccurate charges.
• Review and resolve assigned system work queues and edits to support timely claim generation and billing readiness.
• Apply established charging guidelines, system workflows, and organizational standards during all charge capture activities.
• Ensure completeness and timeliness of charge posting in accordance with defined service level expectations.
• Execute charge capture activities in compliance with internal guidelines and policies, as well as applicable federal and state regulations, and payer requirements.

• Conduct complex, high-risk, and targeted audits in payer-sensitive or error-prone service lines.
• Assess clinical documentation against charging guidelines, payer requirements, and regulatory standards
• Interpret and apply federal, state, and payer regulations in audit determinations.
• Identify compliance risks, documentation opportunities, and inaccurate charging practices.
• Maintain comprehensive audit documentation and reporting to support findings and remediation tracking.
• Support corrective action plans to address identified risks and prevent recurrence.

• Analyze audit findings to determine root causes related to charge capture errors, documentation practices, clinical workflows, or system configuration.
• Provide targeted education and feedback to nursing staff, providers, as well as clinical and operational leaders related to documentation and charging requirements.
• Partner with clinical departments and Revenue Cycle Operations to reinforce documentation and charge capture best practices.
• Contribute to development of tip sheets, policies, audit guidance, and clinical charging…