Revenue Integrity Specialist

City of Hope • Duarte, CA

4d

About The Position

Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.
As a successful candidate, you will:
Serve as a charge capture, charge integrity and charge description master expert to clinical service line leaders and ensures processes are in compliant with Federal/State guidelines. This position identifies revenue opportunities and works collaboratively with revenue cycle and clinical staff to develop a work plan to ensure process improvement is understood by departmental managers and staff and is documented throughout the revenue cycle with the expected outcome being increased revenue capture and decreased denials.

Requirements

• Bachelor's Degree; 3 additional years of experience plus the minimum experience requirement may substitute for minimum education.
• Minimum of three (3) years of experience working in Revenue Integrity/Charge Capture/Coding hospital and/or professional/ambulatory healthcare environment.
• At least three (3) years prior experience performing medical record /charge audit/claim audit reviews
• Must have technical knowledge of correct coding principles of CPT/HCPCS and modifier selection
• Knowledge of Medicare, Medicaid, Medicaid OPPS reimbursement, and other 3rd party billing rules/coverage

Responsibilities

• Serve as a charge capture, charge integrity and charge description master expert to clinical service line leaders and ensures processes are in compliant with Federal/State guidelines.
• Identifies revenue opportunities and works collaboratively with revenue cycle and clinical staff to develop a work plan to ensure process improvement is understood by departmental managers and staff and is documented throughout the revenue cycle with the expected outcome being increased revenue capture and decreased denials.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level