Pre-Billing Integrity Specialist

Sharp HealthCare; Oceanside (CA); On-site; USD 36,000 - 52,000; Full time

Job summary

Sharp HealthCare is seeking a Patient Accounting professional to resolve pre-billing edits and ensure clean claim submissions. The role reports to the Patient Accounting Supervisor and requires two years of charge quality assessment experience in acute care.

Responsibilities include root-cause analysis, modifier reviews, and collaboration with multiple departments to mitigate recurring issues. Strong focus on HIPAA compliance, documentation, and coordination with IT for 3M updates.

Qualifications

• HS Diploma or Equivalent.
• 2 Years experience in the performance of charge quality assessment in an acute care hospital.

Responsibilities

• Resolve pre-billing edits to ensure clean claim submission.
• Identify root causes and coordinate with management across departments to mitigate recurrence.
• Review modifiers and APC/DRG-related edits; re-abstract encounters as needed.
• Collaborate with IT to ensure 3M updates are current and accurate.

Skills

Charge quality assessment

Attention to detail

Education

High School Diploma or equivalent

Associate's Degree

Bachelor's Degree

Job description

Sharp HealthCare is seeking a Patient Accounting professional to resolve pre-billing edits and ensure clean claim submissions. The role reports to the Patient Accounting Supervisor and requires two years of charge quality assessment experience in acute care.

Responsibilities include root-cause analysis, modifier reviews, and collaboration with multiple departments to mitigate recurring issues. Strong focus on HIPAA compliance, documentation, and coordination with IT for 3M updates.