Senior Revenue Integrity Specialist

Senior Revenue Integrity Specialist

Requirements

• Bachelors Degree or Equivalent Experience
• Accounting – 6 years of experience
• ARCR: Resolute Hospital Billing Integrity Certification – EPIC

Responsibilities

• Oversees charge capture and reconciliation processes and provides education for new services added.
• Works with internal customers to ensure newly implemented workflows and procedures support revenue cycle integrity and achieve the revenue cycle’s financial goals.
• Performs daily review of charge items and revenue integrity work queues to ensure accurate and timely resolutions.
• Performs appropriate follow-ups when unusual items are noted and ensure problems are resolved and prevented in the future.
• Performs audits of tests/procedures performed vs. items reported in Hospital Information System to ensure daily charge reconciliations are accurate.
• Responsible for the accuracy and timely setup and maintenance of patient charges for CPT code integrity in compliance of regulatory guidelines along with the consistency and integrity of pricing methodology.
• Coordinates with assigned hospital department heads to gain understanding of clinical services provided and interpret into patient charges.
• Performs analysis of market data to ensure competitiveness of new and existing patient charges.
• Performs advanced level analysis of issues involving charge set up for new and existing patient charges, investigate causes, propose solutions and reports findings to Cost Accounting Director.
• Assists with the maintenance and accuracy of the cost accounting system by coordinating with assigned hospital department heads to gain understanding of clinical services provided and interpret into financial standard costs.
• Assists with the accurate and timely setup and maintenance of the procedural standard costs components in the Strata Cost Accounting System.
• Other duties as assigned.

Preferred Qualifications

No preferred qualifications provided.