Revenue Integrity Specialist

• Department: Revenue Cycle Management
• Schedule: Monday through Friday 
• Work Location: UAB St. Vincent's Birmingham  
• Benefits for eligible positions only include: generous paid time off, paid parental leave, Associate Assistance Program, Tuition Reimbursement Program, and more 

The Revenue Integrity Specialist supports revenue optimization, regulatory compliance, and charge
capture integrity across the enterprise by collaborating with clinical departments, Revenue Cycle, Health
Information Management (HIM), Health Information Technology (IT), and other key stakeholders. This
role performs advanced edits, validations, and in-depth analytical reviews, applying strong judgment to
identify trends, resolve complex issues, and support accurate reimbursement and sustainable revenue
practices.

1. Responsible for ensuring accurate CPT/HCPCS documentation for the patient billing
process and educating colleagues and ancillary departments in accurately documenting
services performed, and using appropriate codes representing those services. Responsible
for charge capture in the Revenue Integrity assigned areas, if applicable. Performs coding
functions, including CPT, documentation review, and claim denial review. Review's
documentation, abstract data, and ensure charges/coding are in alignment with AMA and
Medicare coding guidelines.
2. Responsible for working the pre-bill edits within key metrics, including but not limited to
OCE/CCI, & DNFB.
3. Provides “at-elbow support” to ancillary departments, including but not limited to ensuring
supply charges are appropriately captured (may include implants), identifying duplicate
charges, and initiating appropriate communications when there are documentation and/or
charge deficiencies or charge errors.
4. Performs charge entry, charge approvals, and/or quality charge reviews, including but not
limited to, appending modifiers and checking clinical documentation. Provides feedback to
intra-departmental Revenue Integrity colleagues, including areas of opportunity.
5. Responsible for coding and/or validation of charges for more complex service lines, with
advanced proficiencies in surgical or specialty coding practice.
6. Educates clinical staff on the need for accurate and complete documentation to ensure
revenue optimization and integrity. Provides consultation training and other assistance to
clinical departments regarding charge protocol issues to ensure charge sheets/screens are
updated, and processes are in place to capture all daily charges.
7. Provides ongoing feedback and prepares and analyzes trends relating to clinical and billing
data to identify documentation, coding, and charging issues.
8. Works closely with clinical areas to effectively document services performed and
understand the relationship of documentation, medical necessity, coding and charging for
all services provided.
9. Identifies trends, collaboratively works with leadership to help improve the revenue cycle
performance within the hospital and/or Ambulatory Clinics.
10. Works collaboratively with the revenue-producing department leadership and clinical care
sites to ensure all charges are being documented, captured, and reconciled.

Licenses / Certifications / Registrations

• RHIA, RHIT, CCS, CPC/COC/CIC, AAPC, or other coding credentials required.
• HFMA Certified Revenue Cycle Specialist (CRCS), HFMA Certified Revenue Cycle Specialist (CRCS) certifications preferred.

Minimum Requirements 

• Bachelor’s degree in finance, Accounting, Management, or hospital-related fields.
• Minimum of three years of experience in billing, charge documentation, charge audit, or charge capture activities, or other
  functions related to revenue cycle activities

No Additional Preferences

UAB St. Vincent’s, a proud part of UAB Medicine, is a trusted provider of health care, serving Alabama for more than 125 years. With five hospitals and numerous clinics, we're a health care community deeply rooted in compassion, service, and respect for all, guided by the rich legacy of the St. Vincent’s name. We're committed to extending kindness and personalized care to patients, their families, and each other. We address the physical, psychological, social, and spiritual needs of our patients. We believe in the power of teamwork and unity, and foster a collaborative spirit among our more than 4,800 employees. As one of Alabama’s best hospitals as recognized by U.S. News & World Report, improving the health and lives of those we serve is at the heart of our mission. Join us in continuing our legacy of service and healing in central Alabama, where we can make a lasting impact together.