Senior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (REMOTE) (Exempt) (Non-Union)
Core
Ensures Chargemaster (CDM) consistency with coding/billing regulations, synchronizes data between billing systems and management tools, and leads charge capture improvement initiatives for a multi-entity medical center.
Role type
Senior Revenue Integrity Specialist (Clinical Revenue Integrity)
Builds
Accurate Chargemaster data, compliant charge capture processes, and audit resolution workflows for Keck Medical Center of USC.
Domain
Healthcare Administration / Revenue Cycle Management
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Healthcare revenue cycle management, Chargemaster (CDM) maintenance, Medicare/Medicaid reimbursement methodology, charge audit and reconciliation, policy development, stakeholder leadership, data synchronization, regulatory compliance (state/federal), MS Office proficiency
Preferred skills
Hospital charging practices, acute care operations, Revenue cycle flow knowledge, CDM maintenance software (Craneware/Med Assets), CPT/HCPCS/ICD9 coding principles, Cerner system knowledge, Registered Nurse (RN) licensure, Pharmacy Technician licensure
Technologies
Cerner, Craneware, Med Assets, MS Office
Responsibilities
Maintain Keck & Norris Charge Description Master (CDM) with annual payer updates; review and process new code additions and revenue code corrections; lead meetings with Operations Leaders and Clinical Staff on compliance; coordinate with Revenue Auditors for charge capture research and resolution; synchronize CDM data between billing systems and management tools monthly; import/extract data from various sources to monitor charge flow; provide ad-hoc reports on CDM data; educate clinical staff on CDM maintenance and coding updates; develop policies and monitoring tools for late charges.
Seniority
Senior, hands-on IC with leadership responsibilities