Revenue Integrity Specialist

4 days ago


Springfield, Massachusetts, United States Baystate Health Full time
Job Summary

Baystate Health is seeking a highly skilled Revenue Integrity Specialist to join our team. As a key member of our Revenue Integrity and Advisory Services department, you will play a critical role in ensuring consistent charge capture and billing to promote optimal reimbursement.

Key Responsibilities
  • Ensure timely and accurate processing of Charge Description Master (CDM) additions, deletions, and modifications.
  • Serve as the system administrator for CDM software, coordinating maintenance, interfacing with patient financial systems, and managing user access.
  • Investigate and resolve charging process issues, providing high-level support to other revenue cycle departments.
  • Apply knowledge of Revenue Cycle Business Functions, including Charge Capture, Coding, Billing, and Denial Management, to support revenue cycle initiatives.
  • Monitor and report on financial results, collecting, analyzing, and interpreting key revenue management data.
  • Represent the department on projects and system implementations related to revenue cycle, providing valuable input to ensure success.
  • Perform other duties as requested by management, providing support to new projects as needed.
Requirements
  • 5+ years of related experience in revenue cycle management, charge capture, and billing compliance.
  • Experience with Medicare and Medicaid services (CMS) rules and regulations, coding and billing compliance.
  • Working knowledge of HCFA-1500 and UB-04 claim forms.
  • Demonstrated knowledge of revenue cycle business processes, including scheduling, registration, documentation, coding, charge entry, billing, collections, and reimbursement.
  • Excellent verbal and written communication skills, with the ability to resolve conflicts with tact and diplomacy.
  • Intermediate to advanced skills in Excel, Microsoft Word, Outlook, and PowerPoint.
What We Offer

At Baystate Health, we value diversity, equity, and inclusion. We strive to create a workplace where everyone feels valued, respected, and empowered to contribute their best work. As a Revenue Integrity Specialist, you will have the opportunity to work with a diverse team, contribute to the success of our revenue cycle initiatives, and make a meaningful impact on the financial health of our organization.



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