Revenue Integrity Specialist
7 days ago
We are seeking a highly skilled Revenue Integrity Specialist to join our team at Sturdy Memorial Hospital. The successful candidate will be responsible for ensuring the efficient and effective capture of revenue, while maintaining compliance with federal and state billing regulations.
Key Responsibilities- Revenue Charge Capture: Develop and implement processes to ensure timely and accurate capture of all chargeable activities, including design of procedures in ancillary clinical systems and business systems.
- Charge Description Master Management: Manage the hospital's charge description master, including maintenance of all relevant coding required for billing and reporting.
- Pricing and Contracting: Develop pricing philosophy and techniques to establish new fees for supplies and services, utilizing market data and information to assist in the pricing process.
- Regulatory Compliance: Maintain current working knowledge of federal and state billing regulations, as well as contract provisions in other third-party managed care contracts.
- Financial Analysis: Monitor departmental monthly revenue at a high level and discuss variances with clinical departments as necessary.
- Education: Bachelor's degree or related experience.
- Experience: Two plus years related experience in a hospital or health system.
- Skills: Strong knowledge of medical terminology, clinical procedures (CPT/HCPC), revenue codes and claims processing, modifiers, as well as Medicare regulations related to coding, billing and reimbursement methodologies.
- Computer Proficiency: Computer proficiency (Microsoft Word, Excel), Cerner and 3M preferred.
- Communication and Organizational Skills: Strong communication and organizational skills, with ability to work independently in an organized and systematic manner.
- Masters' Degree: Masters' degree preferred.
The successful candidate must be able to sit for long periods of time, repeat the same movements, use hands to control tools such as computers, see details of objects that are less than a few feet away, speak clearly so listeners can understand, and understand the speech of another person.
Sturdy Memorial Hospital is an equal employment opportunity employer. We are committed to diversity and inclusion in the workplace.
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