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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Expertise in revenue integrity, charge capture, and diagnostic coding, with a strong focus on compliance and billing accuracy. Proficient in collaborating across healthcare teams to enhance coding practices and mitigate revenue risks.
Highest-signal resume keywords
ICD-10-CM KnowledgeCPT Coding ExpertiseRevenue Cycle OperationsProfessional Coding CertificationEpic Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Charge Capture ProcessesBilling Compliance RequirementsCoding Edits AnalysisReimbursement MethodologiesCoding Discrepancy Investigation
Soft Skills
Strong Organizational SkillsProblem-Solving SkillsCross-Functional CollaborationEffective Communication
Tools & Technologies
EpicCharge Review ToolsCoding Work Queues
Certifications & Qualifications
CPCCOCCCSRHIARHIT
Industry Keywords
Revenue IntegrityHealthcare Revenue CycleDiagnostic CodingBilling ComplianceLCD/NCD Regulations
About the role
Key responsibilities & impact- Serve as a subject matter expert on revenue integrity, charge capture, diagnostic coding, and billing compliance
- Review Charge Description Master (CDM) records for coding accuracy, compliance, and integrity
- Investigate coding and charging discrepancies, identify root causes, and implement corrective actions
- Manage and resolve Revenue Integrity tickets related to coding edits, charge capture, CDM maintenance, and billing discrepancies
- Partner with Radiology and Pathology coding teams on ICD-10-CM, ICD-10-PCS, CPT, and HCPCS guideline application
- Evaluate Epic work queues, coding edits, and charge review reports to identify reimbursement risks and revenue leakage
- Collaborate with Revenue Operations, HIM, Billing, and Clinical departments on coding updates and regulatory changes
- Educate clinical and operational stakeholders on coding, charge capture, documentation, and compliant billing
- Present audit findings, revenue integrity trends, and process improvement recommendations to leadership and governance committees
- Report to the Director, Revenue Integrity
Requirements
What you’ll need- Bachelor's degree or equivalent combination of education and relevant healthcare revenue cycle experience
- Strong knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, charge capture processes, and billing compliance requirements, especially related to LCD/NCD regulations
- Professional coding certification required or strongly preferred, including CPC, COC, CCS, RHIA, or RHIT
- Experience collaborating with coding, HIM, revenue cycle, finance, and clinical teams within a complex healthcare environment
- Demonstrated experience analyzing coding edits, denials, charge reconciliation issues, and reimbursement impacts
- Epic experience and familiarity with revenue cycle applications, coding work queues, and charge review tools preferred
- Advanced analytical skills
- Strong understanding of healthcare reimbursement methodologies, coding regulations, and revenue cycle operations
- Ability to communicate complex coding and revenue integrity concepts clearly
- Ability to conduct coding education, training, and audit feedback sessions
- Strong organizational, problem-solving, and cross-functional collaboration skills