Revenue Integrity/Charge Capture Specialist

We are seeking a detail-oriented and highly skilled Revenue Integrity / Charge Capture Specialist to join our healthcare finance team. This critical role is responsible for ensuring the accuracy, completeness, and compliance of charge capture processes across Emergency Department (ED) and Observation services. The specialist will conduct comprehensive reviews of all charges within ED and Observation encounters to identify missed revenue opportunities, validate charge accuracy, and ensure appropriate reimbursement.

The ideal candidate will possess a strong background in revenue integrity, charge reconciliation, outpatient coding, and revenue cycle operations, with experience navigating both Epic and Cerner electronic health record systems. This position plays a key role in minimizing revenue leakage, improving charge capture performance, and supporting the overall financial health of the organization.

Responsibilities

• Review and analyze Emergency Department (ED) and Observation medical records to ensure all applicable charges are captured accurately and completely.
• Perform detailed charge reconciliation and validation of clinical services, procedures, medications, supplies, and ancillary services documented within ED and Observation encounters.
• Audit patient encounters to identify missing, duplicate, inaccurate, or unsupported charges and recommend corrective actions.
• Review medical records, billing documentation, and coding entries to ensure proper charge capture aligns with services rendered and organizational charging policies.
• Verify that procedures, diagnoses, and treatments are accurately coded using CPT, ICD-10-CM, HCPCS, and other applicable coding systems.
• Collaborate with clinical staff, coding teams, CDI specialists, and revenue cycle departments to resolve documentation discrepancies impacting charge capture and reimbursement.
• Utilize both Epic and Cerner EHR platforms to review clinical documentation, validate charges, and perform revenue integrity audits.
• Monitor charge capture trends, identify revenue leakage opportunities, and recommend process improvements to optimize reimbursement.
• Maintain compliance with federal and state regulations, payer guidelines, and organizational policies related to billing, coding, and reimbursement.
• Develop and present reports detailing audit findings, charge capture performance metrics, and revenue recovery opportunities.

Do you have experience in Regulatory compliance?, * Minimum of 3 years of experience in Revenue Integrity, Charge Capture, Revenue Cycle, Medical Coding, or related healthcare financial operations.

• Strong understanding of Emergency Department (ED) and Observation charging methodologies, billing requirements, and reimbursement practices.
• Experience reviewing and reconciling charges within ED and Observation encounters.
• Proficiency in CPT, HCPCS, and ICD-10 coding systems.
• Hands-on experience working within both Epic and Cerner electronic health record systems.
• Knowledge of outpatient facility billing, charge master (CDM) principles, and revenue cycle workflows.
• Strong analytical and problem-solving skills with exceptional attention to detail.
• Ability to interpret clinical documentation and apply regulatory guidelines to support compliant charge capture practices.
• Experience identifying revenue leakage and implementing corrective actions to improve reimbursement outcomes.
• Excellent communication and collaboration skills, with the ability to work effectively across clinical, coding, billing, and finance teams., * CPC, CCS, RHIA, RHIT, or other relevant healthcare coding/revenue cycle certification.
• Previous experience performing Revenue Integrity audits focused on ED and Observation services.
• Experience working with Charge Description Master (CDM) maintenance and charge capture optimization initiatives.

$37 - $42 an hour - Temporary, Full-time, Contract, Pulled from the full job description

• 401(k)
• Health insurance
• Paid time off
• Vision insurance
• Health savings account
• Dental insurance
• Flexible schedule, * 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Health savings account
• Paid time off
• Vision insurance