Revenue Integrity Specialist

5 months ago

Philadelphia, United States Pennsylvania Medicine Full time

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Job Title: Revenue Integrity Specialist
Department: Data Management
Location: Centre Square West Tower- 1500 Market Street
Hours: Full Time

Summary:

  • This position is responsible for supporting Revenue Cycle Operations (RCO) as it relates to front end billing issues, billing exceptions and edits, insurance follow-up and all contracted payment accounts. The scope includes all professional and hospital Services (diagnostic, therapeutic, or surgical) performed or billed through Penn Medicine. Performs daily charge reconciliation and ensures all services are posted to the appropriate department in a timely manner. Work with all departments to maintain a high level of charge integrity, maintain expected charge lag, and enhance reimbursement and decrease denials.
Responsibilities:
  • Utilize health system and external system tools to monitor charges and edits to ensure timely and accurate reimbursement of services rendered.
  • Provide support to front office staff to resolve patient issues.
  • Accurately quote self-pay rates to patients as indicated by the entity guidelines.
  • Enter charges and/or corrections into the appropriate system. Resolve all pre-billing edits and reconcile charge reports within 2 business days
  • Work closely with other teams to proactively identify and resolve issues or variances in expected volumes.
  • Work directly with the leadership team to achieve strategic and operational objectives of the department.
  • Support department leadership in maintaining a high level of charge data integrity.
Credentials:
  • American Association of Healthcare Administrative Management (preferred)
  • Revenue Cycle Certification (preferred)
Education or Equivalent Experience:
  • H.S. Diploma/GED (Required)
  • 3+ years Hospital or Practice Revenue Cycle Setting, working with insurance carriers and medical billing
  • Bachelor of Arts or Science and 2+ years Hospital or Practice Revenue Cycle Setting, working with insurance carriers and medical billing Education Specialization: Healthcare, Finance, Management, or related
We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

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