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Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary:
The Revenue Integrity Specialist-Clinical will perform internal quality assessment claim reviews to ensure compliance with federal, payer and internal Revenue Cycle policies. The position works in coordination with all hospital departments to improve the accuracy, integrity and quality of patient charges and to ensure minimal variation in charging practices across departments. Will respond to requests to research and provide resolution for claim data variances, evaluate payer updates and assist in the performance of chart-to-bill audits to produce and maintain timely, accurate, compliant and inclusive charge capture, coding and billing functions. Works to identify medical necessity and regulatory requirements related to charge integrity and recommend solutions. Responsibilities:
Provides service to internal hospital departments, both clinical and non-clinical and external customers such as UNC Health Care and affiliated system entities, managed care organizations, third party payers and patients by providing quality service, communication and assistance. Performs duties in a manner that projects a positive image of the department and hospital.
LENOIR Other information:
Qualifications
EDUCATION REQUIREMENTS
Graduate from an accredited school of nursing.
PROFESSIONAL EXPERIENCE REQUIREMENT
Minimum of 2 - 4 years of experience in a clinical setting preferred. Experience in Utilization Management, medical audit/review and appeals/denials experience preferred. Knowledge and understanding of CPT/HCPCS coding requirements, third party payer billing and reporting requirements preferred.
LICENSURE/REGISTRATION/CERTIFICATION
North Carolina Registered Nurse License
KNOWLEDGE, SKILLS, AND ABILITIES REQUIREMENTS
Strong verbal, written and interpersonal communication skills. Skills with Microsoft applications including Excel. Ability to research, analyze and interpret healthcare policies, billing guidelines, and state and federal regulations. Knowledge of Medicare/Medicaid regulations, including billing, coding and documentation requirements. Strong analytical and problem-solving skills. Strong understanding of various reimbursement methodologies. Comfortable presenting to and interacting with senior levels of hospital leadership.
WORK ENVIRONMENT
Office setting, possibly subject to many interruptions.
PHYSICAL REQUIREMENT
Sitting, standing and walking throughout shift.
01.9110.4137
Job Details
Legal Employer: Lenoir Health Entity: UNC Lenoir Health Care Organization Unit: Patient Accounting Work Type: Full Time Standard Hours Per Week: 40.00 Work Assignment Type: Onsite Work Schedule: Day Job Location of Job: LENOIR MEM Exempt From Overtime: Exempt: Yes Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
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UNC Health Care
Mar 24, 2026