Revenue Integrity Audit Specialist
Core
Ensures accuracy and completeness of daily charges and CPT code assignments for imaging and procedure labs, investigating clinical and technical report deficiencies to prevent delays in patient care.
Role type
Revenue Integrity Audit Specialist (Coding Specialist)
Builds
Accurate claims and charge descriptions for St. Mary's Hospital and the WI region
Domain
Healthcare administration / Medical billing and coding
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
CPT code assignment, charge reconciliation, clinical report review, documentation compliance, reporting tool usage, audit evaluation, training development
Preferred skills
Knowledge of Charge Description Master (CDM), Charge Preference List (CPL), Flowsheet Charging, coding conference participation
Technologies
Multiple reporting tools, multiple databases
Responsibilities
Investigate and correct errors in work queues to aid in timely and accurate claims; Work one-on-one with staff and Physicians to ensure documentation requirements are met; Create and generate reports to support leadership on strategic initiatives; Complete audit/project evaluations to determine accuracy of orders, charges, and documentation; Maintain current knowledge of charging systems through conferences and workshops; Develop training solutions for charge accuracy and coding/billing compliance
Seniority
Entry-level to Mid-level, hands-on IC