Advises departmental revenue owners and staff on proper use of charge codes, monitors daily charge capture and revenue reconciliation, and identifies opportunities to improve revenue capture and compliance.
This role reviews billing guidelines, regulations, and third-party coverage rules; validates diagnoses and procedure codes; supports internal charge review audits; and partners with Revenue Cycle, IT, clinical departments, and vendors on process improvements, implementation support, and issue resolution.
The position is non-management and reports to a supervisor, manager, director, or executive.
Requirements & Qualifications
Minimum Requirements
- High school diploma or equivalent, or post-high school diploma / highest degree earned
- Five years of healthcare revenue cycle experience
Equivalent Substitutions
- Associate degree plus four years of healthcare revenue cycle experience, including two years of charge description master/revenue integrity experience
- Bachelor's degree plus two years of charge description master/revenue integrity experience
Required Certifications
- LPN, RHIT, RHIA, CCS, CPC, or CBCS
Knowledge, Skills, and Abilities
- Understanding of OPPS, IPPS, ICD-10 coding, HCPCS/CPT coding, and revenue cycle processes
- Ability to interact with diverse groups at all organizational levels and provide guidance and education
- Ability to understand and apply National and Local Coverage Determinations
Location
South Carolina, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
4 months ago