Veterans in Healthcare
Revenue Integrity Specialist - Clinical Revenue Integrity - Full Time 8 Hour Day
Veterans in Healthcare, Los Angeles, California, United States, 90079
Revenue Integrity Specialist - Clinical Revenue Integrity
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Revenue Integrity Specialist - Clinical Revenue Integrity - Full Time 8 Hour Days (REMOTE) (Exempt)
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Veterans in Healthcare . Revenue Integrity (RI) Specialist provides leadership to the daily charge data maintenance workflow between the various entities of Keck Medical Center of USC and monitors the alignment of the various entities to the standard policy for maintaining the Charge Description Master (CDM). The RI Specialist is responsible for the timely and accurate synchronization of data between the CDM residing in the billing system and CDM management tools, ensuring that the CDM is consistent with all coding and billing regulations and accurately represents services provided. Essential Duties
Perform maintenance of the Keck Medical Center of USC Charge Description Master, ensuring all annual updates required by Medicare and other third‑party payers are up to date. Review and process requests for new code additions, code set corrections, revenue code to CPT/HCPCS code mismatch corrections, and ongoing identified changes for current systems to maintain compliance with state and federal regulatory agencies. Participate in meetings with Operations Leaders, Revenue Auditors, Clinical Department Staff, and Gatekeepers to address issues involving compliance with government regulations, third‑party payor needs and industry standards. Act as a subject matter expert for projects that impact revenue integrity and CDM; meet and communicate with stakeholders for such projects. Lead and exercise significant judgement and discretion on projects that have a broad, organizational impact. Coordinate and lead the Revenue/Chart Audit team associated with research and resolution of account issues related to the CDM, charge capture, and other revenue integrity issues. Synchronize CDM data between CDM and CDM Workflow & Management Tool for Keck Medical Center of USC entities monthly. Import/extract data from various sources and in various formats as needed to review, monitor, track, and maintain the integrity of the CDM and associated charge flow process. Provide CDM data as necessary based on identified issues in the form of ad‑hoc reports. Provide guidance and education to ensure that CDM and Charge Capture standards and policies are followed by all entities. Perform charge reconciliation activities, industry best practice research, and identify and deploy charge capture improvement initiatives. Required Qualifications
Associate’s degree in Business Administration, Accounting, Finance, Healthcare Administration or Nursing. Additional 2 years of experience if no associate’s degree. At least 3 years of experience in the healthcare field, including clinical service delivery, coding, billing, medical records, charge audit environment, CDM maintenance, Medicare/Medicaid reimbursement, managed care contractual arrangements, and patient accounting. Experience with inpatient and outpatient billing requirements (UB‑04) and CMS Medicare reimbursement methodology. Knowledge of other government and third‑party payer reimbursement methodology. Ability to implement a systematic, self‑motivated approach to problem solving and coordinate and optimize resources to execute the plan. Proficient skills and knowledge in MS Office/Windows. Preferred Qualifications
Previous hospital Charge Master experience, including the use of CDM maintenance software (Craneware or Med Assets). Experience and knowledge of hospital billing and/or charging practices. Healthcare operations experience, particularly in an acute care hospital setting. Current knowledge of the revenue cycle, specifically the flow of charges in and across hospital billing systems. Working knowledge of CPT, HCPCs and ICD9 coding principles. Skills and knowledge on the following software: Cerner and Craneware. Required Licenses/Certifications
Fire Life Safety Training (LA City). If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date (Required within LA City only). Salary and Compensation
The annual base salary range for this position is $81,120.00 - $133,010.00. When extending an offer of employment, the University of Southern California considers factors such as the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. Posted Date: 10/23/2025 | Employment type: Full-Time | Work Location: Remote (Los Angeles, CA)
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Join to apply for the
Revenue Integrity Specialist - Clinical Revenue Integrity - Full Time 8 Hour Days (REMOTE) (Exempt)
role at
Veterans in Healthcare . Revenue Integrity (RI) Specialist provides leadership to the daily charge data maintenance workflow between the various entities of Keck Medical Center of USC and monitors the alignment of the various entities to the standard policy for maintaining the Charge Description Master (CDM). The RI Specialist is responsible for the timely and accurate synchronization of data between the CDM residing in the billing system and CDM management tools, ensuring that the CDM is consistent with all coding and billing regulations and accurately represents services provided. Essential Duties
Perform maintenance of the Keck Medical Center of USC Charge Description Master, ensuring all annual updates required by Medicare and other third‑party payers are up to date. Review and process requests for new code additions, code set corrections, revenue code to CPT/HCPCS code mismatch corrections, and ongoing identified changes for current systems to maintain compliance with state and federal regulatory agencies. Participate in meetings with Operations Leaders, Revenue Auditors, Clinical Department Staff, and Gatekeepers to address issues involving compliance with government regulations, third‑party payor needs and industry standards. Act as a subject matter expert for projects that impact revenue integrity and CDM; meet and communicate with stakeholders for such projects. Lead and exercise significant judgement and discretion on projects that have a broad, organizational impact. Coordinate and lead the Revenue/Chart Audit team associated with research and resolution of account issues related to the CDM, charge capture, and other revenue integrity issues. Synchronize CDM data between CDM and CDM Workflow & Management Tool for Keck Medical Center of USC entities monthly. Import/extract data from various sources and in various formats as needed to review, monitor, track, and maintain the integrity of the CDM and associated charge flow process. Provide CDM data as necessary based on identified issues in the form of ad‑hoc reports. Provide guidance and education to ensure that CDM and Charge Capture standards and policies are followed by all entities. Perform charge reconciliation activities, industry best practice research, and identify and deploy charge capture improvement initiatives. Required Qualifications
Associate’s degree in Business Administration, Accounting, Finance, Healthcare Administration or Nursing. Additional 2 years of experience if no associate’s degree. At least 3 years of experience in the healthcare field, including clinical service delivery, coding, billing, medical records, charge audit environment, CDM maintenance, Medicare/Medicaid reimbursement, managed care contractual arrangements, and patient accounting. Experience with inpatient and outpatient billing requirements (UB‑04) and CMS Medicare reimbursement methodology. Knowledge of other government and third‑party payer reimbursement methodology. Ability to implement a systematic, self‑motivated approach to problem solving and coordinate and optimize resources to execute the plan. Proficient skills and knowledge in MS Office/Windows. Preferred Qualifications
Previous hospital Charge Master experience, including the use of CDM maintenance software (Craneware or Med Assets). Experience and knowledge of hospital billing and/or charging practices. Healthcare operations experience, particularly in an acute care hospital setting. Current knowledge of the revenue cycle, specifically the flow of charges in and across hospital billing systems. Working knowledge of CPT, HCPCs and ICD9 coding principles. Skills and knowledge on the following software: Cerner and Craneware. Required Licenses/Certifications
Fire Life Safety Training (LA City). If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date (Required within LA City only). Salary and Compensation
The annual base salary range for this position is $81,120.00 - $133,010.00. When extending an offer of employment, the University of Southern California considers factors such as the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. Posted Date: 10/23/2025 | Employment type: Full-Time | Work Location: Remote (Los Angeles, CA)
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