Rev Integrity Specialist - Charge Description Master

Job Details

Support Services | Miamisburg | Full-Time | Days

Job Requirements

Responsibilities & Requirements

• Coding certification CPC-Certified Professional Coder or - Certified Coding Specialist required (external candidates holding, internal candidates with relevant experience certification required 18 months)
• RHIT and RHIA preferred.
• 2–5 years in revenue cycle (e.g. HIM, PFS/Billing, CDM), charge capture, or coding/edit resolution.
• Preferred experience coding in acute outpatient hospital setting.
• Coder, Health Information
• CCS or CPC coding certification required.
• Preferred member of AHIMA and/or AAPC Professional Associations.
• Consideration for other recognized medical coding certifications may be considered with Director approval.
  
  

Job Responsibilities

• Knowledge of healthcare revenue cycle processes in assigned area/department
• Knowledge of regulatory and governing body coding and billing guidelines.
• Ability to navigate Epic EMR & chart auditing for supporting charge related documentation.
• Proficient in data entry using Microsoft Office Suite products.
• Possess strong interpersonal, team building, and analytical skills
• Ability to work with minimal direction
• Ability to prioritize
• Experience resolving CCI, MUE, OCE, EAPG edits.
• Proficiency in Epic or other major EHR/billing scrubbers.
• Strong analytical skills, attention to detail, and familiarity with payer billing regulations
• Review and resolve claim edits in work queues using Epic or billing scrubber systems.
• Apply coding corrections or modifiers in response to CCI, MUE, OCE, and EAPG rejections.
• Consult documentation and coding guidelines (ICD 10, CPT, HCPCS), adjust charges as required.
• Reach out to clinical teams or coders to confirm documentation and corrections.
• Track trends in edits and provide feedback or training to prevent recurring issues.
• Support revenue integrity by auditing denied or held claims and optimizing charge capture.
• Assist with charge master/CDM maintenance and updates based on trend analysis.
• Performs other duties as assigned
  
  

Overview

Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it’s by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.