Charge Integrity Support Specialist - Revenue Integrity - Corporate Office - Day Shift - Full Time

Sharp HealthCare; San Diego (CA); On-site; USD 43,000 - 60,000; Full time

Job summary

Sharp HealthCare in California seeks a Revenue Integrity specialist to optimize charge integrity across the system. You will analyze daily reports, identify systemic issues, and coordinate with departments to ensure accurate charge capture.

The role requires 1 year in hospital charging/coding or revenue cycle, a CA driver's license, and proficiency with Microsoft Office. CPC certification and 3 years in a large hospital setting are preferred.

Qualifications

• 1 year of hospital and ambulatory care charging and coding experience or hospital revenue cycle experience.
• CA driver's license required.
• Bachelor's degree preferred; could substitute four years of relevant experience.

Responsibilities

• Analyze daily reports, work queues, and vendor portals to identify charge issues.
• Conduct root cause analysis and propose solutions for charge integrity.
• Collaborate with the Revenue Integrity Team to implement improvements.
• Follow up with clinical, coding, billing and operational contacts to resolve issues.

Skills

Hospital charging

Coding practices

Revenue cycle

Driver's license

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Hours

Shift Start Time: Variable

Shift End Time: Variable

AWS Hours Requirement: 8/40 - 8 Hour Shift

Additional Shift Information

Weekend Requirements: As Needed

On-Call Required: No

Hourly Pay Range (Minimum - Midpoint - Maximum)

$31.350 - $39.180 - $43.890

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

To be the operational subject matter expert on all charge integrity solutions, coordinate revenue enhancement opportunities for all entities supported by the System Revenue Integrity Department and in alignment with the overall mission of Sharp HealthCare.

Required Qualifications

• 1 Year experienced with hospital and ambulatory care charging and coding practices, or hospital revenue cycle, or contractual payment schemes.
• Driver's License - CA Department of Motor Vehicles - REQUIRED

Preferred Qualifications

• 3 Years Experience in a large hospital setting, medical group, or consulting company.
• Certified Professional Coder (CPC) - AAPC - PREFERRED

Other Qualification Requirements

• Bachelor's degree or relevant experience in excess of four years may be substituted for degree. - Preferred
• Utilizes reliable transportation and possesses adequate personal insurance coverage. Demonstrates clean driving record in accordance with requirements of the employer DMV pull notice program and Sharp HealthCare Driver Guidelines.

Essential Functions

Analyzes, Evaluates, and Reports

Reviews and follows-up on daily reports, system work queues and/or vendor portal to identify accounts that have potential lost, over, undocumented, duplicate charges. Identify, trend and report potential systemic issues to Charge Integrity Team for resolution. Conduct root cause analysis of charge integrity issues and provide recommendations.

Follow up directly with department to ensure charges are entered onto accounts timely.

Reviews and follows-up on daily reports to identify late charges.

Researches, identifies, prioritizes, and communicates charge integrity opportunities. Demonstrates superb attention to detail and analytical thinking skills.

Department Support and Teamwork

Maintains expertise in accurate charge entry and coding requirements, collaborates with coding compliance specialist(s).

Work collaboratively across disciplines and communicate with various customers while seeking solutions. Might be assigned to support key clinical areas on a need basis.

Department System Competency

Maintains expertise in charge source criteria and IT interfaces from upstream systems.

Assists in deploying technology solutions, developing standard approaches, tools, reports, communication, policies and procedures to be utilized across the system.

Problem Resolution

Reviews and follows-up on issues in assigned work-queues.

Follows-up with clinical, coding, billing and operational contacts to resolve revenue integrity concerns in a timely manner.

Assigns actions, turnaround times to appropriate parties, monitors progress and results, reports out to management. Contributes to analytical, technical and operations problem solution efforts.

Works with revenue integrity, finance and clinical leadership to develop, implement charge capture entry, validation, reconciliation and correction processes; developing and implementing protocols, policies and procedures to support charge capture accuracy and timeliness.

Demonstrate Effective Self-direction and Time Management Skills

Practices strong organizational and project management skills. Manages workflows and tasks by prioritizing, planning, and executing. Embodies and complies with Sharp behavioral standards.

Keeps current with trends, developments in the profession, industry and related fields of expertise.

Knowledge, Skills, and Abilities

Must have an understanding of Revenue Cycle concepts and knowledge of clinical concepts.

Must be proficient with Microsoft Office Applications.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class