Revenue Integrity Auditor

Job Description

Location: Tampa, FL (Greater Metro Area)

We are seeking a Revenue Integrity Auditor to safeguard revenue accuracy by reviewing charge capture processes, identifying billing discrepancies, and ensuring alignment between clinical services rendered and charges submitted. This role bridges clinical operations and finance to protect reimbursement and reduce compliance risk across the organization.

This position is built for someone who can read a medical record, understand the clinical context, evaluate whether the charges match the documentation, and articulate the gap when they do not. You will be the organization’s front line of defense against revenue leakage and charge capture errors.

Responsibilities:

• Conduct charge capture audits across departments to verify that services documented are accurately reflected in billing
• Analyze charge description master (CDM) entries for compliance with CPT, HCPCS, and revenue code standards
• Identify charge leakage patterns through data analysis and recommend corrective workflows to department leadership
• Partner with department directors, clinical managers, and coding teams to resolve charge capture gaps
• Review late charges, missed charges, and charge corrections to quantify revenue impact and identify root causes
• Support annual CDM maintenance including new charge code implementation, pricing updates, and regulatory alignment
• Prepare audit findings reports with root cause analysis and actionable recommendations for operational improvement
• Assist with compliance reviews related to the OIG Work Plan, CMS billing rules, and payer audit responses
• Conduct focused reviews of high-risk charge areas including surgical services, infusion, observation, and ancillary departments
• Monitor charge lag metrics and work with departments to reduce days from service to charge posting
• Validate appropriate modifier usage, bundling compliance, and global period adherence across procedure charges
• Support EHR charge capture workflow design and optimization initiatives
• Collaborate with compliance on self-disclosure and voluntary refund determinations when billing errors are identified
• Maintain current knowledge of CMS OPPS, IPPS, and professional fee billing requirements

Qualifications:

• Bachelor’s degree in Health Information Management, Healthcare Administration, or related field required
• Minimum 3 years of experience in revenue integrity, charge capture, or healthcare auditing
• Strong knowledge of CPT, HCPCS, ICD-10-CM, and APC/DRG reimbursement methodologies
• Experience with CDM management tools and EHR revenue cycle modules
• CCS, CPC, or RHIA certification preferred
• Analytical mindset with excellent problem-solving and presentation skills
• Proficiency with data analysis tools including Excel, SQL, or BI platforms
• Strong communication skills for presenting audit findings to clinical and financial stakeholders

Schedule:

• Full-time position
• Standard business hours
• Standard full-time hours per pay period

Salary Range: The salary range for this position is approximately $68,000 – $82,000 annually ($32.69 – $39.42 per hour), based on experience and qualifications. Relocation assistance may be available for qualified candidates.

Interview Process:

• Selected candidates will participate in a multi-step interview process, including an initial screening with TalentLNX followed by interviews with department leadership.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and prohibits discrimination and harassment of any kind. We are dedicated to building a diverse workforce and fostering an inclusive work environment where all employees and candidates are treated with respect and dignity. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or any other protected status under applicable law. We actively seek to recruit, develop, and retain talented individuals from diverse backgrounds and we encourage all qualified candidates to apply for our job opportunities.