Revenue Integrity & Charge Capture Analyst

Eisenhower Health; Rancho Mirage (CA); On-site; USD 50,000 - 76,000; Full time

Job summary

Eisenhower Health in Rancho Mirage, CA seeks a Revenue Cycle Auditor to perform integrity audits within the Charge Descriptive Master and related processes. The role requires CPC/CCS certification within a year and 2 years of billing or auditing experience.

Responsibilities include ensuring proper charging, guiding staff on charge capture, and reviewing reports to improve compliance and reimbursement. A strong analytical, collaborative approach is essential.

Qualifications

• Education: Required: High school diploma, GED or higher level degree; Preferred: medical coding coursework or bachelor’s degree in related field
• Licensure/Certification: Required: CPC or CCS within one year if hired after Jan 1, 2021
• Experience: Required: Two years of medical billing, charge capture, coding or patient account auditing experience; Preferred: revenue cycle experience, hospital/clinical experience

Responsibilities

• Demonstrates compliance with Code of Conduct and compliance policies and reports suspected violations.
• Performs audits of all revenue generating departments’ CDM files and conducts departmental interviews to ensure proper recording and compliance with state and federal guidelines.
• Provides guidance and education to staff on correct charge capture, current charging structure, and billing and coding processes to eliminate duplicate, inactive or non-compliant charges.
• Prepares and submits audit findings to leadership with recommendations.
• Assesses the accuracy of charge capture tools and recommends changes to meet standards.
• Reviews facility bill rejection reports to correct, edit or apply modifiers for compliant billing.
• Examines reports and makes recommendations regarding deficiencies in controls or compliance.
• Assists department charge custodians in completing their identified bill rejection charges.
• Maximizes collection by understanding payor contracts and makes recommendations to improve payments.
• Acts as liaison between Revenue Recognition, Charge Master, Payor Relations and PFS for charge structures and rates.
• Identifies process improvements and participates in hospital process improvement teams.
• Performs other duties as assigned.

Skills

Analytical thinking

Root cause analysis

Interpersonal relations

Financial analysis

Charge capture workflows

Research skills

Written and verbal communication

Education

High school diploma or equivalent

Medical coding coursework or related degree preferred

CPC/CCS certification within 1 year

Tools

PC applications

Database knowledge

Reporting tools

Job description

Eisenhower Health in Rancho Mirage, CA seeks a Revenue Cycle Auditor to perform integrity audits within the Charge Descriptive Master and related processes. The role requires CPC/CCS certification within a year and 2 years of billing or auditing experience.

Responsibilities include ensuring proper charging, guiding staff on charge capture, and reviewing reports to improve compliance and reimbursement. A strong analytical, collaborative approach is essential.