Clinic Revenue Integrity Auditor — Billing & Coding

CommonSpirit Health; Sacramento (CA); On-site; USD 34,000 - 47,000; Full time

Job summary

Dignity Health - Methodist Hospital in Sacramento, CA is hiring a Clinic Data Audit Specialist who will ensure accurate billing by auditing documentation for medical necessity and proper charges within the electronic medical record. You will work closely with finance, accounting, and coding to ensure compliant and correct coding for claims.

The role requires meticulous attention to detail and strong knowledge of ICD/CPT coding, billing procedures, and regulatory guidelines.

Qualifications

• High School Diploma or GED with at least 1 year in medical billing/claims.
• Knowledge of ICD and CPT coding in a clinic setting.
• Auditing documentation for medical necessity and proper charges.
• Familiarity with Cerner or similar EHR and payer guidelines.

Responsibilities

• Demonstrates attention to detail to minimize coding errors, performs compliance and quality audits, and ensures accurate billing
• Print and use the Arrived Patient List to capture all encounters
• Cerner PCA Charge Viewer: Review each Encounter to make sure there is a diagnosis charge and the note is CoSigned by a Preceptor
• Check BP Codes for HPMG Incentive
• View Office Visit Charges (Delete Duplicates)
• Validate Modifiers (GC – w Faculty / GE –w/o Faculty Modifier)

Skills

Attention to detail

Billing/auditing

ICD coding knowledge

CPT coding knowledge

Education

High School Diploma or GED

Tools

IDX systems

Cerner PCA Charge Viewer

Job description

Dignity Health - Methodist Hospital in Sacramento, CA is hiring a Clinic Data Audit Specialist who will ensure accurate billing by auditing documentation for medical necessity and proper charges within the electronic medical record. You will work closely with finance, accounting, and coding to ensure compliant and correct coding for claims.

The role requires meticulous attention to detail and strong knowledge of ICD/CPT coding, billing procedures, and regulatory guidelines.