ED Revenue Integrity Specialist II, Remote

📋 Description

• • Own the financial heartbeat of the Emergency Department from the comfort of your home. As the ED Revenue Integrity Specialist II you will perform daily, high-impact audits and charge reconciliation that directly determine how quickly and accurately UofL Health can bill for life-saving care. Every keystroke you make translates into dollars that fund new equipment, additional nurses, and expanded community programs.
• • Monitor the live ED patient board every morning, reviewing census and discharge data to confirm that every required piece of documentation is present before charges are released. Your vigilance prevents revenue leakage and keeps the organization compliant with CMS guidelines.
• • Assign the correct ED facility E/M level, procedures, injections, infusions, and administration charges using CMS Official Coding Guidelines and the proprietary points tool. You will append the right ICD-10-CM, CPT, and HCPCS Level II modifiers so that claims sail through clearinghouses on the first pass.
• • Drive down Discharge Not Final Bill (DNFB) days by resolving pre-bill edits within 24–48 hours. Your speed and accuracy shorten the revenue cycle, improve cash flow, and allow patients to receive clearer statements faster.
• • Partner shoulder-to-shoulder with ED physicians, charge nurses, and unit clerks to close documentation gaps. Whether it is a missing start/stop time for an infusion or an unsigned procedure note, you will tactfully coach clinicians so that every service rendered can be ethically billed.
• • Serve as the go-to subject-matter expert for infusion and injection charging, ED leveling, and high-acuity case scenarios. You will field real-time questions from coders, billers, and clinical staff and translate complex guidelines into plain language.
• • Generate trend reports that spotlight recurring charge entry errors or payer denials. Present your findings to Revenue Cycle leadership and recommend system-level fixes that prevent future losses—your insights shape policy and training across the entire health system.
• • Maintain productivity standards by keeping all ED charges entered within three business days of discharge while simultaneously resolving pre-bill edits. You will balance speed with surgical-level accuracy, ensuring every claim is audit-proof.
• • Champion continuing education by attending CMS webinars, AHIMA workshops, and internal lunch-and-learns. You will distill new regulations into quick-reference guides and share them with the broader revenue integrity team.
• • Leverage advanced EMR and billing system skills—Cerner and McKesson STAR preferred—to navigate patient records, charge routers, and claim-scrubbing software. Your technical fluency allows you to spot anomalies that others miss.
• • Demonstrate UofL Health’s core values in every interaction: integrity, excellence, collaboration, and service orientation. Whether you are on a Zoom call with an ED director or emailing a bedside nurse, your communication style will be clear, respectful, and solution-focused.
• • Contribute to special projects such as CDM updates, chargemaster reviews, and new service line implementations. Your experience will help the organization launch new procedures or infusion protocols with revenue integrity baked in from day one.
• • Protect patient privacy and organizational data at all times. You will follow HIPAA, internal audit guidelines, and cybersecurity best practices while working 100 % remotely.
• • Celebrate wins—when monthly DNFB drops, denial rates fall, or cash collections spike, you will know that your meticulous work behind the scenes made those victories possible.