Revenue Integrity Specialist

Job Title: Revenue Integrity Specialist

Location: System Business Office

Department Name: Revenue Integrity

Req #: 0000270070

Status: Salaried

Shift: Day

Pay Range: $76,200.00 - $95,300.00 per year

Pay Transparency:

The above reflects the anticipated annual salary range for this position if hired to work in New Jersey.

The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience.

Job Summary:

As the Revenue Integrity Specialist, you will assist the Revenue Integrity Manager in performing daily tasks. The specific tasks for this process include, but are not limited to the following with a focus on professional charges:

• Coordinate Quarterly and Annual Code Updates
• Charge Master Maintenance
• Monitors for Regulatory changes
• Supports clinical department & physician practice / new service line development
• Audit and monitoring
• Multidisciplinary Team Collaboration
• Promote efficiencies

As a Revenue Integrity Specialist, a typical day might include:

• Maintain up to date knowledge on all CMS & AMA publications as it pertains to code additions, revisions and deletions to share with appropriate clinical departments for education & compliance by regulatory due date. Responsible for coordinating updates to charge capture tools. Audit changes to ensure clinical and financial build are accurate and complete schedule updates, while keeping clinical and financial builds accurate.
• Maintain CDM accuracy by reviewing CPT/HCPCS, modifiers, and pricing based on CMS guidelines and organization polices.
• Monitors CMS regulatory changes that impact charging compliance. Assess impact and coordinate necessary updates.
• Assess new service offerings to determine appropriate and compliant charging. Complete post implementation audits to ensure charges are reported accurately.
• Develop and submit an annual service line audit plan to the Revenue Integrity Manager and conduct reviews to ensure accurate quantities, modifiers, and CPT coding.
• Collaborate with multidisciplinary teams to evaluate operational and IT changes, ensure compliant charge capture and documentation, support charge testing and monitoring, and provide timely guidance and recommendations to optimize revenue integrity and financial performance.
• Analyze trends in edits and work queues to identify root causes, recommend and implement improvements with clinical and IT collaboration, and communicate resulting changes to impacted staff.
• Perform Special Projects for the Manager/Assistant Vice President of Revenue Integrity and other duties as assigned

This role might be for you if you have the following qualities:

• Provides a compassionate and supportive environment with prompt and consistent service.
• Adheres to patient rights: provides for the confidential treatment of all communications and records.
• Demonstrates professionalism with families, visitors, physicians, co-workers and supervisors.
• Supports teamwork by cooperative problem solving through participation in meetings, projects, etc.
• Utilizes principles of continuous quality improvement in all work situations to assess, measure and improve organizational and department functions.
• Organizes work sets priorities with a minimum of supervision and seeks guidance as appropriate
• Makes decisions that are timely and consistent with department, objectives, policies and procedures.
• Demonstrates sound judgment; accepts and benefits from constructive criticism

To be considered for this opportunity, you must meet the following requirements:

• HS Diploma or equivalent
• Bachelor's Degree (BA or BS) in business, finance or a healthcare related field preferred
• Preferred Certifications & Licenses: Registered Nurse (RN), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) or Certified Professional Coder (CPC)
• Excellent interpersonal and communication skills to positively interact with a variety of hospital personnel, including administrative and management staff. Possess effective oral and written skills. Ability to interpret and implement regulatory standards.
• Demonstrated success performing CDM reviews, CPT/HCPCS coding expertise, billing and reimbursement knowledge. ICD-10 coding knowledge.
• Excellent organizational and project management skills. Possess effective time management skills to permit handling of multiple projects simultaneously
• Epic experience preferred

Why You'll Love Working Here:
At RWJBarnabas Health, our people are at the center of everything we do. Through our Total Wellbeing promise, we offer a wide range of benefits and resources to support your physical, emotional, financial, and professional wellbeing. Highlights include:

• Generous Paid Time Off (Vacation, Holidays, Sick Time)

• Medical, Dental & Vision Insurance

• Prescription Drug Coverage

• Retirement Plans

• Paid Parental Leave

• Tuition Reimbursement

• Student Loan Planning Support

• Life and Disability Insurance

• Wellness Programs and Flexible Spending Accounts

• Voluntary Benefits (like Pet Insurance)

• Discounts with local partners (e.g., NJ Devils, NJPAC, Verizon)

• Community involvement and volunteer opportunities ...and more!

Why RWJBarnabas Health:
RWJBarnabas Health is New Jersey's largest and most comprehensive academic health system, committed to delivering exceptional care and creating healthier communities. We're proud to offer a workplace that values compassion, equity, and innovation-where every team member plays a vital role. When you join us, you're not just building a career-you're helping to shape the future of healthcare, one person and one community at a time.