Revenue Integrity Coordinator

OMNI FAMILY HEALTH•Bakersfield, CA

3d•$25 - $30

About The Position

Under the supervision of the Revenue Integrity Supervisor, the Revenue Integrity Coordinator provides revenue integrity support to Omni Family Health’s network of health centers in California’s Central Valley. As part of the Fiscal Department, the Coordinator supports accurate and compliant charge capture, documentation, coding, and billing of clinical services. The role safeguards revenue by identifying discrepancies, preventing revenue leakage, and promoting compliance with regulatory and payer requirements. It emphasizes prospective review and continuous process improvement to identify systemic issues before they affect claims, optimize charging workflows, and ensure clinical services are documented and billed correctly.

Requirements

High school diploma or GED certificate.
At least two years of experience in revenue cycle management, medical billing, or a related field.
Demonstrated experience supporting charge reconciliation, documentation review, or revenue integrity functions.
Familiarity with split-billing software, reporting tools, and electronic health record systems such as NextGen.
Working knowledge of 340B regulatory guidance, billing practices, and HRSA audit preparedness.
Foundational knowledge of drug pricing, reimbursement methodologies, and coding principles.
Proficiency in Microsoft Office, including Word, Outlook, and Excel.
Strong analytical and problem-solving skills, including the ability to interpret complex billing and utilization data.
Exceptional attention to detail and commitment to data integrity, accuracy, and regulatory compliance.
Ability to work independently, prioritize multiple tasks, and manage competing deadlines in a fast-paced environment.
Professionalism and discretion when handling sensitive, confidential, and protected health information.
Collaborative, team-oriented approach and strong customer-service skills, with the ability to work effectively across clinical, administrative, and revenue cycle teams.

Nice To Haves

Associate’s degree in Pharmacy, Health Information Technology, Business, Healthcare Administration, or a related field.
340B Apexus Advance Certification (ACE).
Experience in a Federally Qualified Health Center, multi-clinic healthcare, or nonprofit setting.

Responsibilities

Monitor charge capture to ensure clinical services are accurately documented and submitted for billing according to organizational and payer requirements.
Review daily charges for completeness and accuracy, identify missing, duplicate, or incorrect charges, and coordinate corrections with departments.
Identify discrepancies between documentation and billed services, investigate revenue leakage, and recommend process improvements to leadership.
Collaborate with the coding team to support accurate use of CPT, HCPCS, and ICD-10 codes aligned with documentation.
Partner with Managed Care and Revenue Cycle Management teams to reduce denials and outstanding claims; analyze payer-denial trends related to coding or documentation and communicate patterns to help prevent recurring errors.
Support Accounts Receivable review, monthly reconciliation, KPI monitoring, and presentation of findings to leadership and clinical teams.
Review vendor billing workflows for medication services across medical, pharmacy, and retail pharmacy settings, including UDS, FQHC PPS, Managed Care, and Medicare/Medicaid billing models.
Support contract pharmacy performance reviews, operational oversight, and revenue optimization.
Monitor payer policy updates concerning drug reimbursement, prior authorization, and formulary coverage.
Review pharmacy, medical, and dental utilization, reimbursement data, and KPIs—including 340B savings, denial trends, and revenue leakage—to support improvement efforts.
Ensure billing practices comply with CMS, Medicare, Medi-Cal, payer guidelines, and other federal, state, and program-specific requirements.
Maintain compliance with local, state, and federal regulations related to revenue integrity and billing.
Support internal audits, self-audits, and HRSA audit readiness by maintaining documentation, identifying compliance risks, and assisting with corrective action plans.
Educate departments on documentation practices that support compliant billing and accurate charge capture.
Partner with Finance and clinical departments to streamline charging workflows and improve operational efficiency.
Support leadership reporting for internal stakeholders and Board-level updates concerning program performance, revenue integrity, and compliance.
Pull and analyze revenue integrity reports, including charge lag, late charges, and denial trends, to identify patterns and drive improvement.
Support the department’s mission, vision, and core values while delivering superior customer service.
Work with corporate branches, divisions, and departments in accordance with Omni policies and procedures.
Perform other duties and responsibilities as assigned.
Travel may be required.
Maintain awareness of and comply with HIPAA regulations and requirements.
Participate as required in QA/QI activities and contribute to organizational quality improvement initiatives.
Learn and use the electronic health record and related systems as required, including NextGen, PMS, QSI, and other applicable electronic features.
Participate in Patient Centered Medical Home activities.
Contribute to HRSA, OSV, Joint Commission, and other audit events.
Respect the confidentiality of general personnel and patient-related information.
Promote and support Omni’s mission statement and relate to the public without regard to race, ethnicity, religion, age, sex, disability, or economic status.