Revenue Integrity Coding Analyst

4 weeks ago

Bloomington, United States i-Health Full time
Description

Be the primary partner between the Coding and PFS team to ensure coding denials are reduced and worked in a timely manner.

This is a full-time position working M-F from 8:00 am - 5:00 pm and is based out of our Revo Health Corporate Office in Bloomington.

Revo Health is a professional services company that partners with multiple healthcare groups to deliver exceptional patient care. This position will be employed by Revo Health, working closely with Infinite Health Collaborative (i-Health) and its operating divisions. We have a comprehensive Medical, Dental & Vision Plan, Maternity Bundle, 401K with Profit Sharing, Tuition Reimbursement, Gym & Car Rental Discounts and more.

Essential functions:

  • Monitor and manage edits software to optimize clean claims rate and minimize denials.
  • Manage coding denial queues.
  • Partner with Coders and PFS Specialists to reduce number of touches required to collect accounts receivable.
  • Perform analysis of denied claims to identify trends impacting revenue
  • Assist PFS Specialists in submitting appeal and successful
  • Effectively communicate claim trends to aid in finalizing outstanding
  • Investigate and correspond with insurance companies or other third-party payors to understand denied claims and required efforts toward
  • Research changes in payer requirements and communicate new or changing requirements to Revenue Cycle Leadership.
  • Act as subject matter expert for i-Health practice claim denials.
  • Any and all other duties as assigned

Education and Experience Requirements:

  • High School diploma/GED or equivalent
  • Minimum of 5 years' experience in billing operations preferred
  • Minimum of 5 years' experience in coding preferred
  • Minimum of 2 years' experience in RCx Rules or other edits software
  • CPC preferred

Essential Requirements:

Ability to:

  • Comply with company policies, procedures, practices and business ethics
  • Complete job required
  • Comply with all applicable laws and regulations, (e.g. HIPAA, Stark, OSHA, employment laws, )
  • Maintain prompt and reliable attendance
  • Work in the clinic, office or surgery center during business hours
  • Travel independently throughout the clinic, office or surgery center (which may include movement from floor to floor); frequent bending, lifting, stooping or sitting for long periods of time may be required
  • Work at an efficient and productive pace, handle interruptions appropriately and meet deadlines
  • Converse in a respectful and professional manner
  • Prioritize workload while being flexible to meet the expectations of the daily operations
  • Apply principles of logical thinking to define problems, establish facts, and draw valid conclusions
  • Understand and execute a variety of instructions
  • Effectively operate equipment and communicate on and operate the phone system
  • Work independently with minimal supervision
  • Travel to other work locations, if required

Performance Expectations - Revo's Core Values:

  • Integrity - Do the right thing and take responsibility for what you do and say
  • Service - Consistently contribute to deliver an exceptional experience
  • Quality - Act with high purpose, committed effort, and skillful execution to exceed expectations
  • Innovation - Identify progressive solutions that improve service, teamwork, efficiency, and/or effectiveness
  • Teamwork - Be a part of the whole; support each other positively

Environmental Conditions:

  • Normal clinic/office setting

Notes:

  • Revo is an Equal Opportunity/Affirmative Action Employer and will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990 and the ADA Amendments Act of 2008.
  • The knowledge, skills, abilities & traits (KSATs) listed on this job description are typically acquired through the levels of education and experience listed. However, any equivalent combination of education and/or experience, which provide an applicant with the listed KSATs to perform the essential functions and requirements of the job is acceptable.
  • This job description will be reviewed periodically as duties and responsibilities change with business necessity. Essential job functions are subject to modification.





Infinite Health Collaborative (i-Health) is an Equal Employment/Affirmative Action employer and will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990 and the ADA Amendments Act of 2008.

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