Charge Integrity Specialist

Charge Integrity Specialist

Role

The Charge Integrity Specialist will play an important role in SmarterDx’s next product launch in the Charge Integrity space. This role will work closely with Product and Data science to refine and and collaborate on strategies that will assist our customers in decreasing missed or incorrect charges before billing. This role will have a creative and clinical view of the product and assist in defining models, rules and workflows that will help serve as best-in-class representation of charge integrity strategies. 

**This role is primarily remote within the US but infrequent (1-2 times/year) travel may be required**

What You’ll Do

• Review and refine technology-generated Charge Integrity findings, ensuring they align with industry best practices and regulatory requirements, and that they are accurate and valuable to our customers
• Collaborate with cross-functional teams to develop and optimize charge integrity strategies, along with creating and defining methodologies and rules that scale, focusing on missed or incorrect charges.
• Oversee the quality control process, owning the integrity of charge integrity findings and ensuring consistency across all team outputs.
• Interact with clients to present rationale for findings and to summarize feedback for internal teams 
• Play a key role in evolving the charge integrity workflow by providing insights and recommendations that influence product development and improvements.

What You Bring

• 3-5+ years of hands-on experience in revenue integrity strategies, with hands-on experience in creating charge capture and charge integrity rules and processes in inpatient and outpatient settings.
• A solid understanding of the charge integrity landscape, with experience in leading teams and ensuring quality control in high-stakes environments.
• Previous experience, or a strong interest, in advising or consulting for healthcare technology companies, with a passion for leveraging technology to streamline clinical processes.

Must Haves

• Nursing degree
• Revenue background, with the ability to grow and contribute across multiple functions as the role evolves.
• Professional billing experience including reviewing charges from medical coders and performing audits

Nice To Haves

• Previous advising experience with technology companies
• Strong leadership abilities, particularly in managing teams that review patient charts and draft clinical denial appeals.
• AAPC certifications such as Certified Professional Biller (CPB), Certified Outpatient Coder (COC), or Certified Professional Medical Auditor (CPMA)
• Experience with interventional radiology, orthopedics, and/or gastroenterology billing

• For candidates with RN degree: $115 to $140K + equity incentives

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