Senior Revenue Integrity Lead – Charge Master Expert

Veterans in Healthcare; Los Angeles (CA); On-site; USD 99,507 - 164,559; Full time

Job summary

Keck Medical Center of USC in Los Angeles is seeking a Senior Revenue Integrity Specialist – Clinical Revenue Integrity. You will lead the daily CDM maintenance workflow, ensuring the Chargemaster aligns with coding and billing regulations and payer requirements.

You will supervise revenue auditors, collaborate with administration, IS, compliance, and clinical informatics, and provide expert guidance on CDM and charge capture across the organization.

Qualifications

• Associate’s degree in a related field.
• Certification in CPC/CCS/COC or CPMA within one year of hire.
• Minimum five years of healthcare experience including coding, billing, CDM maintenance, and Medicare/Medicaid reimbursement.
• Experience with inpatient (UB-04) and CMS Medicare reimbursement methodologies.
• Knowledge of government and third-party payer reimbursement methodologies.
• Ability to coordinate resources for plan execution and problem solving.
• Proficiency in MS Office and Windows.

Responsibilities

• Maintain the Keck Medical Center of USC Charge Description Master and ensure annual updates for Medicare and payers.
• Review and process requests for code additions and corrections, and align CDM with changes.
• Lead meetings with operations leaders and auditors to address compliance issues.
• Serve as SME for projects affecting revenue integrity and the CDM.
• Coordinate and lead the Revenue/Chart Audit team to resolve CDM issues.
• Synchronize CDM data between CDM and management tool monthly.
• Import/export data to monitor CDM integrity and generate ad-hoc reports.
• Educate staff on CDM and charge capture standards across entities.
• Conduct charge reconciliation and deploy capture improvement initiatives.
• Explain charge service details as needed and collaborate on education programs.

Skills

MS Office

Windows proficiency

Coordination

Education

Associate’s degree in Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or related field

Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or related field

Tools

Cerner

Craneware

MedAssets

Job description

Keck Medical Center of USC in Los Angeles is seeking a Senior Revenue Integrity Specialist – Clinical Revenue Integrity. You will lead the daily CDM maintenance workflow, ensuring the Chargemaster aligns with coding and billing regulations and payer requirements.

You will supervise revenue auditors, collaborate with administration, IS, compliance, and clinical informatics, and provide expert guidance on CDM and charge capture across the organization.