Revenue Integrity Audit Specialist
Core
Subject matter expert supporting imaging and procedure lab charges, charge reconciliation, and claim accuracy.
Role type
Revenue Integrity Audit Specialist (Coding Specialist)
Builds
Accurate claims and timely patient care workflows
Domain
Healthcare (Imaging and Procedure Lab)
Required skills
CPT code assignment, charge reconciliation, clinical report investigation, documentation compliance, reporting tool usage, audit evaluation, Charge Description Master (CDM) management, training development
Preferred skills
Coding conferences attendance, self-guided learning, strategic initiative support
Technologies
Multiple reporting tools, multiple databases, Charge Description Master (CDM), Charge Preference List (CPL), Flowsheet Charging
Responsibilities
Investigate and correct errors in work queues to aid timely and accurate claims; Ensure accuracy and completeness of daily charges and CPT code assignment; 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 CDM, CPL, and Flowsheet Charging through conferences and workshops.
Seniority
Mid-level, hands-on IC
