Rev Integrity Specialist - Charge Description Master

Kettering Health•Miamisburg, OH

1d•Onsite

About The Position

Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it’s by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.

Requirements

Coding certification CPC-Certified Professional Coder or - Certified Coding Specialist required (external candidates holding, internal candidates with relevant experience certification required 18 months)
2–5+ years in revenue cycle (e.g. HIM, PFS/Billing, CDM), charge capture, or coding/edit resolution.
Coder, Health Information
CCS or CPC coding certification required.

Nice To Haves

RHIT and RHIA preferred.
Preferred experience coding in acute outpatient hospital setting.
Preferred member of AHIMA and/or AAPC Professional Associations.
Consideration for other recognized medical coding certifications may be considered with Director approval.

Responsibilities

Knowledge of healthcare revenue cycle processes in assigned area/department
Knowledge of regulatory and governing body coding and billing guidelines.
Ability to navigate Epic EMR & chart auditing for supporting charge related documentation.
Proficient in data entry using Microsoft Office Suite products.
Possess strong interpersonal, team building, and analytical skills
Ability to work with minimal direction
Ability to prioritize
Experience resolving CCI, MUE, OCE, EAPG edits.
Proficiency in Epic or other major EHR/billing scrubbers.
Strong analytical skills, attention to detail, and familiarity with payer billing regulations
Review and resolve claim edits in work queues using Epic or billing scrubber systems.
Apply coding corrections or modifiers in response to CCI, MUE, OCE, and EAPG rejections.
Consult documentation and coding guidelines (ICD 10, CPT, HCPCS), adjust charges as required.
Reach out to clinical teams or coders to confirm documentation and corrections.
Track trends in edits and provide feedback or training to prevent recurring issues.
Support revenue integrity by auditing denied or held claims and optimizing charge capture.
Assist with charge master/CDM maintenance and updates based on trend analysis.
Performs other duties as assigned