Revenue Integrity Specialist

This is a full-time, benefit eligible position located in San Diego. The position is remote and requires you to be local in San Diego.

Why join Scripps Health?

At Scripps Health, your ambition is empowered and your abilities are appreciated:

• Nearly a quarter of our employees have been with Scripps Health for over 10 years.
• Scripps is a Great Place to Work Certified company for 2025.
• Scripps Health has been consistently ranked as a top employer for women, millennials, diversity, and as an overall workplace by various national publications.
• Becker’s Healthcare ranked Scripps Health on its 2024 list of 150 top places to work in health care.
• We have transitional and professional development programs to create a learning environment that enables you to thrive in your specific field as well as in your overall career.
• Our specialties have been nationally recognized for quality in areas such as cardiovascular care, oncology, orthopedics, geriatrics, obstetrics and gynecology, and gastroenterology.

The Revenue Integrity Specialists primary functions are daily management / resolution of revenue capture work queues (Account, Charge Review and Charge Router Review) that are designed to identify charge issues prior to billing and conducting quality and accuracy assessments of ancillary service area charge capture processes and clinical documentation for the care provided. Assessment includes review of the CPT/HCPCS codes associated with the procedural charges selected by the clinicians and coders, validation of the required documentation elements to support the services provided and charged, review of the charge capture processes including applicable charge sheets for supplies, medications, implants, procedures, validates accuracy and timeliness of charge entry. Provides timely feedback to ancillary care providers on quality and accuracy assessment. Able to evaluate and monitor coded diagnosis, coded procedures, and charges following National Correct Coding Guidelines, Medicare Integrated Code Editor, medical necessity, and regulatory billing guidelines. Identifies correct code and sequences the diagnoses and procedures using ICD-10-CM, CPT, HCPCS and modifier assigned on accounts.

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