Charge Integrity Specialist - Revenue Integrity

General Duties

• Review patient charges to validate accurate entry and support by clinical documentation.
• Ensure charges match procedures and services using appropriate charge capture standards.
• Assist in daily resolution of revenue integrity edits that prevent accounts from billing by reviewing the medical record and applicable documentation.
• Identify and investigate discrepancies or missing charges in patient accounts, and resolve them.
• Report issues and participate in resolution of any potential or actual revenue/charge related issues.
• Coordinate Charge Description Master (CDM) error findings with the CDM team.
• Monitor EPIC Revenue Integrity Dashboard(s) and RI assigned work queues to assist in completion and timeliness of work meeting Department standards.
• Respond promptly to departmental charging inquiries and document questions to create a repository.
• Provide support for assigned cost centers within service lines in collaboration with charge integrity teammates.
• Work with Coding and other clinical departments to identify and resolve errors based on ICD/CPT Coding Guidelines and NCCI edits.
• Contribute to quarterly improvement initiatives directed by revenue integrity leadership.
• Serve as primary service line representative for all charge related inquiries and issues, ensuring proper usage of charge codes.
• Offer feedback on identified issues and potential solutions, fostering process improvement.
• Monitor and report charge capture trends, providing input on improvements that prevent revenue leakage.
• Perform quality work within deadlines and/or key performance indicators (KPIs) with or without direct supervision.
• Interact professionally with coworkers and customers, working both independently and as a team contributor.
• Deliver a positive patient experience where applicable.
• Complete mandatory training and education sessions within approved organizational guidelines and time frames.
• Perform other miscellaneous duties as assigned.

• Required:
  
  2 years’ experience in a hospital setting, revenue cycle, healthcare industry, or coding.
• Preferred: EPIC HB/PB experience.

• Minimum:
  High school diploma or GED with equivalent combination of certification and experience.
• Preferred:
  Associate’s degree in Healthcare Administration, Health Information, or related field.

• Certification:
  Applicable professional certification through AHIMA (CCA) or AAPC (CPC‑A, COC‑A) highly desirable.
• Must obtain credential within 6 months of employment, or be Epic Certified.

• Interpersonal and communication skills, analytic and organizational skills, critical thinking, and the ability to meet deadlines.
• Computer skills: MS Office (Word, PowerPoint, Excel, Outlook), Windows OS, and Internet.

Days (United States of America)

LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.