We are honored to share that all seven of our eligible hospitals have been named top performers in the 2025 Bernard A. Birnbaum, MD, Quality Leadership Rankings by Vizient Inc., a trusted national benchmark for hospital performance.
This year, five of our hospitals ranked in the top five of their …
Revenue Integrity Specialist
Location:
Corporate
1701 Sunset, Houston TX, 77005
1701 Sunset, Houston TX, 77005
- Job Ref:
- JR-589
- Talent Area:
- Administrative
- Job Shift:
- Day
- Job Type:
- Full Time
At Houston Methodist, the Revenue Integrity Specialist position is responsible for ensuring that the appropriate charges are assigned and entered into the system for accurate patient registration and/or billing. This position accurately enters data and makes edits as required; performs data integrity checks and daily reconciliation of charges and accounts; assists in auditing and in correcting documentation issues; and generates, copies, and distributes reports as directed by management. The Revenue Integrity Specialist also maintains a current and accurate Charge Description Master (CDM) in accordance with coding regulations and guidelines and updates procedure codes as required. Additional responsibilities include monitoring for trends and identifying missed revenue opportunities and areas for potential revenue enhancement.
FLSA STATUS
Non-exempt
QUALIFICATIONS
EDUCATION
EXPERIENCE
SKILLS AND ABILITIES
ESSENTIAL FUNCTIONS
PEOPLE ESSENTIAL FUNCTIONS
SERVICE ESSENTIAL FUNCTIONS
QUALITY/SAFETY ESSENTIAL FUNCTIONS
FINANCE ESSENTIAL FUNCTIONS
GROWTH/INNOVATION ESSENTIAL FUNCTIONS
SUPPLEMENTAL REQUIREMENTS
Non-exempt
QUALIFICATIONS
EDUCATION
- Associate’s degree or higher in billing, coding, accounting, or related field; or high school diploma with additional two years of related experience (in addition to the minimum experience requirements listed below) in lieu of college degree
EXPERIENCE
- Three years of experience in patient accounting, revenue cycle, coding, or other related area
SKILLS AND ABILITIES
- Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
- Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
- Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
- Familiarity with general International Classification of Disease (ICD) and Current Procedural Terminology (CPT) coding
- Knowledge of medical terminology
- Understanding of accreditation and government regulations (e.g., CMS) as applicable to scope of department
- Ability to be self-motivated and work independently with minimal supervision
- Proficient computer skills in Microsoft Office components, including Excel, and ability to learn and navigate multiple software programs
- Ability to think critically, analyze and solve problems
- Strong organizational skills
- Ability to handle detail work accurately and rapidly
- Ability to follow-through and handle multiple tasks simultaneously
ESSENTIAL FUNCTIONS
PEOPLE ESSENTIAL FUNCTIONS
- Promotes a positive work environment and contributes to a dynamic team focused work unit that actively helps one another to achieve optimal departmental and organizational results.
- Develops, fosters and maintains a network of all organizational stakeholders involved in charge entry and processing to assist in the efficient resolution of charge reconciliation issues. Responds to questions regarding charge capture, serves as a subject matter expert in the area of charge capture, and trains/mentors others in related charge capture roles.
SERVICE ESSENTIAL FUNCTIONS
- Performs data entry of clinical and/or operational information from worksheets and other data collection and reporting tools. Accurately enters all data into applicable databases ensuring timeliness and prevention of backlog. Identifies errors, performs problem solving, makes edits and updates records accordingly.
- Handles work queues daily, organizes workflow, problem-solves, and manages multiple ongoing priorities with minimal supervision. Generates, copies, and distributes reports as directed by management.
- Independently utilizes available resources to include electronic tools (e.g., electronic health records, spreadsheets, etc.) to gain understanding of process and edits in order to identify and resolve charge correction and/or registration issues.
- Works daily with external and/or internal areas such as payors (where appropriate), information technology, registration, health information management, and/or billing to address edit issues that require specialized analysis; triages issues to appropriate department(s) to promote resolution identified.
QUALITY/SAFETY ESSENTIAL FUNCTIONS
- Evaluates charges and validates accuracy. When inaccurate, makes revisions by adding, editing, and/or deleting inappropriate charges.
- Identifies and corrects charging errors involving transfer of charges to correct accounts as appropriate.
- Maintains current and accurate Charge Description Master (CDM) in accordance with coding regulations and guidelines and updates procedure codes as required.
- Maintains strict confidentiality of patients, employees and hospital information at all times. Ensures protection of private health and personal information. Adheres to all Health Insurance Portability and Accountability Act (HIPAA) and Payment Card Industry (PCI) compliance regulations.
FINANCE ESSENTIAL FUNCTIONS
- Ensures charges are audited, entered, and confirmed within timeframe set forth by Houston Methodist in order to meet Accounts Receivable (AR) Days metrics. Enters charges as required while closely adhering to system documentation.
- Evaluates charges to ensure billing integrity and works with physicians and clinicians on documentation amendments as necessary to optimize reimbursement. Develops and implements charge reconciliation processes and tools for the clinical operations team to effectively use on the front end.
- Monitors for trends and identification of missed revenue opportunities and areas for potential revenue enhancement.
GROWTH/INNOVATION ESSENTIAL FUNCTIONS
- Displays initiative to improve accuracy and timeliness of charge capture and documentation. Takes an active role in establishing consistency across respective stakeholders as changes in processes, tools, and overall practices are developed and implemented.
- Keeps abreast of market and payor trends as they relate to the department. Actively engages in personal assessment and expands learning beyond baseline competencies with a focus on continual development (i.e., participates in training opportunities, focal point review activity, etc.). Applies new learning.
SUPPLEMENTAL REQUIREMENTS
- WORK ATTIRE
- Uniform: No
- Scrubs: No
- Business professional: Yes
- Other (department approved): Yes
- On Call* No
- May require travel within the Houston Metropolitan area No
- May require travel outside Houston Metropolitan area No
ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.
TRAVEL**
**Travel specifications may vary by department**
Company Profile:
Houston Methodist is one of the nation’s leading health systems and academic medical centers. Houston Methodist consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the heart of the Texas Medical Center, and seven community hospitals throughout the greater Houston area. Houston Methodist also includes an academic institute, a comprehensive residency program, a global business division, numerous physician practices and several free-standing emergency rooms and outpatient facilities. Overall, Houston Methodist employs more than 27,000 employees and is supported by a wide variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care.
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