Revenue Integrity Specialist

3 weeks ago


Stamford, Connecticut, United States TAL Healthcare Full time

**Job Title:** Revenue Integrity Specialist

We are seeking a skilled Revenue Integrity Specialist to join our team at TAL Healthcare. This role plays a critical part in maintaining positive relationships with assigned departments, ensuring they follow charge reconciliation processes and meet key performance indicator metrics.

**Key Responsibilities:*

  • Ensure charges are built correctly in the CDM and integrated with clinical charging mechanisms.
  • Audit and provide feedback on charge capture tools.
  • Oversight of Department charges and KPIs, ensuring they meet budget and determining root cause if not.
  • Train departments on charge capture tools, rules, regulations, CPT/HCPCS updates, and workflows.
  • Monitor, investigate, and resolve revenue integrity concerns and violations reported in their area and provide necessary follow-ups.
  • Serve as a resource for organizational and operational revenue integrity issues.
  • Communicate and lead CDM maintenance activities.
  • Work RI WQs, monitor department WQs. Provide feedback based on WQ volumes, audit outcomes, and daily charge statistics.
  • Validate/test/audit charge triggers to ensure systems are working as expected.
  • Keep abreast of healthcare industry trends.

**Requirements:*

  • Bachelor's degree from an accredited college in business administration or healthcare.
  • 3+ years' experience in a healthcare business setting, including full scope revenue cycle, charging, and performance benchmarking.
  • Effective communication skills and ability to interact with others positively.
  • Ability to manage multiple concurrent activities.
  • Working knowledge of healthcare coding and billing rules and regulations.
  • Strong analytical and organizational skills.
  • Computer skills essential. Microsoft Office and healthcare software (ex: Epic, Meditech) at a minimum.

**Estimated Salary:** $90,000 - $110,000 per year, depending on experience. We offer a competitive salary package, opportunities for growth and development, and a dynamic work environment. If you are passionate about delivering high-quality services and contributing to the success of our organization, we encourage you to apply.



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