Revenue Integrity Specialist (Charge Capture & Compliance)

Bryan Health; Lincoln (NE); On-site; USD 65,000 - 90,000; Full time

Job summary

Bryan Health is seeking a Revenue Integrity/Billing Specialist to ensure accurate charging practices and compliant revenue cycle processes across departments. You will review pre-bill edits, resolve discrepancies, and maintain chargemaster data to support proper reimbursement.

Role requires knowledge of CPT/HCPCS, government/non-government billing, and denial management. Collaborative and independent work with clinical teams to drive improvements and maintain regulatory compliance will be

Qualifications

• Knowledge of claims practices including governmental and non-governmental billing.
• Knowledge of revenue cycle processes, hospital billing, CDM, and UB billing requirements.
• Knowledge of coding systems, reimbursement methodologies, and regulatory guidelines, including CPT, HCPCS, NCCI edits, Medicare LCDs/NCDs, DRG, OPPS, and managed care reimbursement.
• Knowledge of hospital compliance requirements and applicable state and federal healthcare regulations.
• Knowledge of denial management processes, including appeals, root cause analysis, and process improvement strategies.

Responsibilities

• Review and resolve charge capture issues, pre-bill edits, and billing discrepancies to ensure accurate reimbursement.
• Analyze charge review work queues and reporting data to identify trends and root causes.
• Verify billing data accuracy and ensure compliance with payer and regulatory requirements.
• Collaborate with clinical and operational teams to correct errors and improve documentation and workflows.
• Maintain and update chargemaster data to support compliant and accurate charging practices.
• Conduct audits of accounts and documentation to validate appropriate charge capture and billing.
• Provide education to departments on documentation, coding, and revenue integrity practices.
• Monitor regulatory updates and implement changes to maintain compliance with billing requirements.

Skills

Charge capture

Revenue cycle

CDM/chargemaster

Regulatory guidelines

Denial management

Analytics

Communication

Documentation review

Collaborative work

Independent work

Education

High school diploma or equivalent

Job description

Bryan Health is seeking a Revenue Integrity/Billing Specialist to ensure accurate charging practices and compliant revenue cycle processes across departments. You will review pre-bill edits, resolve discrepancies, and maintain chargemaster data to support proper reimbursement.

Role requires knowledge of CPT/HCPCS, government/non-government billing, and denial management. Collaborative and independent work with clinical teams to drive improvements and maintain regulatory compliance will be