Revenue Integrity Specialist

1 week ago


Providence, Rhode Island, United States Care New England Health System Full time
Job Summary

We are seeking a highly skilled Revenue Integrity Specialist to join our team at Care New England Health System. The successful candidate will be responsible for ensuring complete and accurate charge capture through review of medical record documentation of clinical services and procedures.

Key Responsibilities
  • Perform charge reconciliation activity to ensure optimal charge capture in accordance with Medicare, Medicaid, or Third Party payor guidelines.
  • Classification systems include ICD-9-CM, CPT, HCPCS, and other specialty financial systems required for charging, billing, and reimbursement analysis.
  • Provide trending information on a monthly basis, analyzing charge capture and reconciliation data.
  • Assist with identification, reporting, analysis, and resolution of information system problems.
  • Provide back-up resource for report analysis and account corrections.
Requirements
  • Bachelor's Degree in Business Administration or Healthcare Finance Required, Master's Degree Preferred.
  • At least 5 years of hospital and finance work experience.
  • Quantitative and financial analysis skills; time management skills with ability to prioritize projects to meet deadlines.
  • Competent in Microsoft Office suite applications.
  • Claims processing, database management, and statistical analysis skills preferred.


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