About this role
Role Overview
Evaluate and validate AI tools that identify revenue leakage, improve charge accuracy, and ensure coding and billing compliance. This role applies hands-on charge capture and revenue integrity expertise to audit AI outputs, maintain the charge description master, analyze charge patterns, and collaborate with clinical, coding, and billing teams to close gaps and reduce compliance risk. You will also annotate AI-generated recommendations to create structured training data that improves model performance.
Key Responsibilities
- Oversee charge capture, charge integrity, and revenue integrity functions to ensure accurate and compliant charge submission.
- Evaluate AI-generated charge review outputs, coding recommendations, and revenue integrity alerts for accuracy and compliance.
- Conduct charge audits to identify missed charges, duplicate charges, and charge capture errors across clinical departments.
- Manage and maintain the charge description master, ensuring accuracy of charge codes, revenue codes, and pricing.
- Analyze charge patterns to identify revenue leakage opportunities and implement corrective action plans.
- Collaborate with clinical, coding, and billing teams to resolve charge capture discrepancies.
- Monitor KPIs including charge lag times, charge capture accuracy rates, and revenue integrity findings.
- Ensure compliance with CMS billing guidelines, OIG work plan priorities, and payer-specific requirements.
- Annotate AI outputs and provide structured feedback to support AI training datasets.
Qualifications
- Minimum 5 years of experience in charge capture, charge integrity, revenue integrity, or healthcare compliance.
- Deep knowledge of charge description master management, revenue codes, charge capture workflows, and billing compliance.
- Strong understanding of CMS billing guidelines, Medicare Part A and Part B billing rules, and OIG compliance requirements.
- Proficiency with charge capture systems, electronic health record platforms, and revenue integrity tools.
- Experience conducting charge audits and developing corrective action plans.
- Exceptional written and verbal English communication skills.
- High attention to detail, with the ability to identify billing errors and compliance risks in AI-generated outputs.
Preferred Qualifications
- CPC, CCS, CHFP, or CRCS credential.
- Experience with 340B drug program charge capture and compliance.
- Background in hospital, health system, or physician group revenue integrity operations.
- Familiarity with AI tools and comfort evaluating AI-generated charge and billing content.
- Experience with revenue integrity software platforms and analytics tools.
Work Terms
- Location: Remote.
- Employment type: hourly.
Compensation
- Rate: 88 - 88 hourly.
Why Join
- Contribute to the development of next-generation AI systems in healthcare.
- Collaborate with a leading AI research organization on high-impact revenue integrity projects.
- Gain exposure to cutting-edge AI workflows that shape the future of healthcare billing and compliance.