Revenue Integrity Specialist
2 months ago
About Gateway Regional Medical Center
We are a leading healthcare provider, dedicated to delivering high-quality medical services to our patients and their families. Our commitment to excellence is reflected in our state-of-the-art facilities and our team of skilled healthcare professionals.
Our Mission
We strive to provide compassionate and personalized care to every patient, every time. Our goal is to improve the health and well-being of our community, while maintaining a culture of professionalism and respect.
Job Summary
The Revenue Integrity Specialist plays a critical role in ensuring the accuracy and completeness of patient charges. This position is responsible for reviewing and analyzing medical and financial data to identify areas for improvement and implementing changes to optimize revenue capture.
Key Responsibilities
- Charge Capture
- Review observation patient records daily to ensure accurate charge capture, including carving out hours when patients are not actively receiving observation services.
- Validate charges by department to ensure accuracy and completeness.
- Ensure all documents requiring provider signatures are complete and accurate.
- Revenue Analysis
- Analyze revenue and usage reports to identify trends and areas for improvement.
- Develop and implement strategies to optimize revenue capture and reduce errors.
- Compliance and Audit
- Act as a hospital representative for internal and external third-party defense audits.
- Develop and maintain systems for recording audit activities, outcomes, and financial impact of findings.
Requirements
To be successful in this role, you will need:
- Minimum 2 years of experience working with clinical staff and documentation in an acute care setting.
- Knowledge of healthcare industry accepted billing and audit practices.
- Knowledge of the Charge Description Master and how it relates to accurate billing processes.
- Knowledge of common procedural coding and medical terminology.
What We Offer
We offer a competitive salary and benefits package, as well as opportunities for professional growth and development. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.
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