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Revenue Integrity Specialist

4 months ago

Ithaca, United States Cayuga Medical Center Full time

Company Overview:

Cayuga Health is the region's leading healthcare system, and most trusted driver of integrated health services, together with valued partners. We empower our people and employ our capabilities to equitably improve the well-being of the communities we serve. At Cayuga Health System, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies, and research protocols. We have a commitment to its employees by providing competitive rates and compensation, a comprehensive employee benefits programs, attractive working conditions, and the chance to build and explore a career opportunity by offering professional development.

Nestled in the beautiful Finger Lakes region, Cayuga Health provides an outstanding place to work in a vibrant community. Come discover all that Ithaca, New York and Cayuga Health has to offer

Job Summary: The Revenue Integrity Specialist ensures consistent edit resolution to promote optimal reimbursement by timely completion and appropriate management of pre and post billing edits. Attention to detail is a critical component of this position, as well as the ability to communicate with insurance companies, other areas within the revenue cycle, and clinical areas. Members of the Revenue Cycle Team work independently, but are flexible and collaborate to ensure that departmental goals are met.

Position Overview:

  • Determines and executes the best approach for timely resolution of accounts with edits.
  • Responsible for accuracy and compliance of accounts in terms of billing edits
  • Maintains current knowledge of Federal, State and Managed Care billing methodologies, rules and regulations.
  • Understands hospital charge capture process and compliance issues and has the ability to provide resolution by performing research, utilizing third party payor regulations, referencing billing guidelines and CMS guidelines.
  • Identifies root cause of issues related to edits and coordinates efforts with hospital departments to minimize recurring edits related to billing and registration.
  • Identifies automation opportunities
  • Attends and participates in department staff meetings and other meetings as assigned
Minimum Qualifications:
  • Minimum of high school diploma/GED with 5 years' billing experience or
  • Associates Degree with 2 years' billing experience
Experience:
  • Minimum of five (5) years' billing experience in an institutional setting.
  • Medical terminology with working knowledge of ICD-10, CPT and HCPCS codes.
  • Experience using Microsoft Office suite including Word and Excel.
Licensure:
  • Billing or coding certification preferred
Physical Requirements:
  • Lifting up to 20 pounds, standing or sitting for extended periods of time, as well as repetitive use of hands and fingers

At this time Cayuga Health System will not sponsor a new applicant for employment authorization for this position.

If you are interested in applying for this position and you require an accommodation, please contact Cayuga Health System at

Cayuga Health System Commitment to Diversity, Equity & Inclusion

Cayuga Health System commits to treating all people with dignity so that everyone who comes to us is safe, cared for, and respected. We will support the growth of our employees and the health of our community by embracing the rich diversity of social and cultural identities, needs, and life circumstances of all people. We strive to recognize and overcome personal biases and systemic policies that marginalize others and contribute to disparities in healthcare access, equitable care, and good health outcomes.

Cayuga Health is dedicated to our vision for diversity, equity, and inclusion. As we strive towards our vision, we welcome the opportunity to work alongside a diverse range of employees.