Charge Integrity Specialist - Revenue Integrity

100 LCMC Health; Louisiana (MO); Hybrid; USD 60,000 - 80,000; Full time

Job summary

LCMC Health in Louisiana seeks a Revenue Integrity Specialist to review charges, validate clinical documentation, and ensure charge capture accuracy across EPIC systems. You will resolve billing barriers and coordinate with coding and CDM teams to prevent revenue leakage.

Ideal candidates have 2+ years in healthcare revenue cycle or coding, AHIMA/AAPC credentials, and MS Office proficiency. EPIC HB/PB experience preferred; certification within 6 months required.

Qualifications

• High school diploma or GED; associate degree preferred.
• EPIC HB/PB experience preferred.
• AHIMA CCA or AAPC CPC-A certification desirable; Epic certification.
• Must obtain credential within 6 months of employment or be Epic Certified.

Responsibilities

• Review patient charges to validate accurate entry and support by clinical documentation.
• Ensure charges match procedures and services using charge capture standards.
• Resolve revenue integrity edits to prevent accounts from billing.
• Identify and resolve discrepancies or missing charges in patient accounts.
• Monitor EPIC Revenue Integrity Dashboards and RI queues to meet KPIs.
• Coordinate CDM error findings with the CDM team.
• Provide feedback to improve processes and prevent revenue leakage.
• Interact professionally with coworkers and customers; deliver a positive patient experience.

Skills

Interpersonal skills

Communication skills

Analytical thinking

Organizational skills

Deadline oriented

MS Office

Windows OS

Internet

Education

High school diploma or GED

Associate's degree in Healthcare Administration / Health Information

AHIMA CCA / AAPC CPC-A

Tools

EPIC HB/PB

Job description

General Duties

• Review patient charges to validate accurate entry and support by clinical documentation.
• Ensure charges match procedures and services using appropriate charge capture standards.
• Assist in daily resolution of revenue integrity edits that prevent accounts from billing by reviewing the medical record and applicable documentation.
• Identify and investigate discrepancies or missing charges in patient accounts, and resolve them.
• Report issues and participate in resolution of any potential or actual revenue/charge related issues.
• Coordinate Charge Description Master (CDM) error findings with the CDM team.
• Monitor EPIC Revenue Integrity Dashboard(s) and RI assigned work queues to assist in completion and timeliness of work meeting Department standards.
• Respond promptly to departmental charging inquiries and document questions to create a repository.
• Provide support for assigned cost centers within service lines in collaboration with charge integrity teammates.
• Work with Coding and other clinical departments to identify and resolve errors based on ICD/CPT Coding Guidelines and NCCI edits.
• Contribute to quarterly improvement initiatives directed by revenue integrity leadership.
• Serve as primary service line representative for all charge related inquiries and issues, ensuring proper usage of charge codes.
• Offer feedback on identified issues and potential solutions, fostering process improvement.
• Monitor and report charge capture trends, providing input on improvements that prevent revenue leakage.
• Perform quality work within deadlines and/or key performance indicators (KPIs) with or without direct supervision.
• Interact professionally with coworkers and customers, working both independently and as a team contributor.
• Deliver a positive patient experience where applicable.
• Complete mandatory training and education sessions within approved organizational guidelines and timeframes.
• Perform other miscellaneous duties as assigned.

Experience Qualifications

• Required: 2 years’ experience in a hospital setting, revenue cycle, healthcare industry, or coding.
• Preferred: EPIC HB/PB experience.

Education Qualifications

• Minimum: High school diploma or GED with equivalent combination of certification and experience.
• Preferred: Associate’s degree in Healthcare Administration, Health Information, or related field.

Licenses and Certifications

• Certification: Applicable professional certification through AHIMA (CCA) or AAPC (CPC‑A, COC‑A) highly desirable.
• Must obtain credential within 6 months of employment, or be Epic Certified.

Skills and Abilities

• Interpersonal and communication skills, analytic and organizational skills, critical thinking, and the ability to meet deadlines.
• Computer skills: MS Office (Word, PowerPoint, Excel, Outlook), Windows OS, and Internet.

Work Shift

Days (United States of America)

EEO Statement

LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.