Revenue Integrity Coordinator

salinasvalleyhealth; Salinas (CA); On-site; USD 64,000 - 76,000; Full time

Job summary

Salinas Valley Health in Salinas, CA seeks a Revenue Integrity Coordinator to support the hospital's revenue integrity program, ensuring accurate charge capture and compliant billing practices while preventing revenue leakage.

The role liaises with Revenue Cycle, HIM, Coding, Compliance, and IT; conducts audits, analyzes data, maintains chargemaster accuracy, and assists with regulatory compliance to maximize net patient revenue.

Qualifications

• Education: High school diploma or GED required.
• Experience: Two (2) years in revenue integrity within a hospital preferred; five (5) years in healthcare revenue cycle operations required.
• Proficient with Medicare/Medicaid regulatory requirements and chargemaster processes.

Responsibilities

• Perform routine reviews of charge capture processes to ensure accurate revenue recognition.
• Monitor charging practices and identify opportunities to improve revenue cycle performance and reduce revenue leakage.
• Investigate and resolve charging, coding, billing, and reimbursement discrepancies.
• Analyze claim edits, denials, and payment variances to identify root causes and recommend corrective actions.
• Support revenue recovery initiatives by identifying missed charges and reimbursement opportunities.
• Assist with maintenance, validation, and periodic review of the hospital Chargemaster.
• Collaborate with departmental leaders to implement charge updates and service changes.
• Participate in Chargemaster audits and testing activities.
• Conduct revenue integrity audits to evaluate charging accuracy and regulatory compliance.
• Support compliance with Medicare, Medicaid, commercial payer, and regulatory requirements.
• Assist with internal and external audit requests and documentation.
• Identify compliance risks and elevate findings appropriately.
• Collect, analyze, and interpret revenue cycle data to identify trends and performance improvement opportunities.
• Prepare reports related to charge capture, denials, reimbursement variances, and audit findings.
• Monitor key performance indicators and communicate findings to leadership.
• Assist with financial impact analyses related to revenue integrity initiatives.
• Work closely with clinical departments, Coding, HIM, Finance, Patient Access, and Patient Financial Services to resolve revenue cycle issues.
• Participate in workflow improvement projects to enhance revenue capture and billing accuracy.
• Assist with implementation of new services, procedures, and system updates affecting charging and reimbursement.
• Provide guidance and education to operational departments regarding charging and documentation requirements.
• Support training related to revenue integrity policies, billing compliance, and charge capture processes.

Skills

Revenue integrity

Charge capture

Billing compliance

Education

High school diploma or GED

Job description

It's fun to work in a company where people truly BELIEVE in what they're doing!

We're committed to bringing passion and customer focus to the business.

Department: Patient Financial Services

The Revenue Integrity Coordinator is responsible for supporting the hospital's revenue integrity program by ensuring accurate charge capture, compliant billing practices, reimbursement optimization, and prevention of revenue leakage. This position serves as a liaison between clinical departments, Revenue Cycle, Health Information Management (HIM), Coding, Compliance, Patient Financial Services, and Information Technology to promote accurate documentation, charging, coding, and billing processes. The coordinator conducts audits, analyzes revenue cycle data, identifies process improvement opportunities, supports Chargemaster maintenance, and assists with regulatory compliance initiatives to maximize net patient revenue while maintaining adherence to federal and state regulations.

Revenue Integrity Operations

• Perform routine reviews of charge capture processes to ensure accurate and complete revenue recognition.
• Monitor charging practices and identify opportunities to improve revenue cycle performance and reduce revenue leakage.
• Investigate and resolve charging, coding, billing, and reimbursement discrepancies.
• Analyze claim edits, denials, and payment variances to identify root causes and recommend corrective actions.
• Support revenue recovery initiatives by identifying missed charges and reimbursement opportunities.

Chargemaster Management

• Assist with maintenance, validation, and periodic review of the hospital Chargemaster.
• Ensure charge descriptions, HCPCS/CPT codes, revenue codes, and pricing structures are accurate and compliant.
• Collaborate with departmental leaders to implement charge updates and service changes.
• Participate in Chargemaster audits and testing activities.

Compliance and Audit Support

• Conduct revenue integrity audits to evaluate charging accuracy and regulatory compliance.
• Support compliance with Medicare, Medicaid, commercial payer, and regulatory requirements.

Revenue Integrity Coordinator

• Assist with internal and external audit requests and documentation.
• Identify compliance risks and elevate findings appropriately.

Revenue Analysis and Reporting

• Collect, analyze, and interpret revenue cycle data to identify trends and performance improvement opportunities.
• Prepare reports related to charge capture, denials, reimbursement variances, and audit findings.
• Monitor key performance indicators and communicate findings to leadership.
• Assist with financial impact analyses related to revenue integrity initiatives.

Cross-Functional Collaboration

• Work closely with clinical departments, Coding, HIM, Finance, Patient Access, and Patient Financial Services to resolve revenue cycle issues.
• Participate in workflow improvement projects designed to enhance revenue capture and billing accuracy.
• Assist with implementation of new services, procedures, and system updates affecting charging and reimbursement.

Education and Support

• Provide guidance and education to operational departments regarding charging and documentation requirements.
• Support training efforts related to revenue integrity policies, billing compliance, and charge capture processes.
• Maintain current knowledge of healthcare reimbursement methodologies and regulatory updates.

Education: High school diploma or GED required.

Licensure: None.

Experience: Two (2) years of progressive experience in a revenue integrity capacity within a hospital environment preferred. Five (5) years of experience in healthcare revenue cycle operations required. Demonstrated track record of success in revenue cycle operations. Experience in monitoring and analyzing revenue cycle trends, variances and opportunities for improvement. Understanding in payer compliance and chargemaster review and maintenance processes.

Pay Range: The hourly rate for this position is $46.70 - $55.00 The range displayed on this job posting reflects the target for new hire salaries for this position.

Job Specifications:

• Union: Non-Affiliated
• Work Shift: Day Shift
• FTE: 1.0
• Scheduled Hours: 40

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!