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Revenue Cycle Integrity Analyst

2 months ago

Philadelphia, Pennsylvania, United States Pennsylvania Medicine Full time

Penn Medicine is committed to our tripartite mission of delivering exceptional patient care, pioneering innovative research, and training the next generation of leaders in the medical field. Joining this prestigious academic medical center means collaborating with top-tier clinical, technical, and business professionals across various disciplines.

At Penn Medicine, each day presents an opportunity for breakthroughs. Our employees play a vital role in healing, providing hope, and offering comfort. Are you ready to contribute to our mission?

Position Title: Revenue Integrity Specialist
Department: Data Management
Employment Type: Full Time

Position Overview:

This role is essential in supporting Revenue Cycle Operations (RCO) concerning front-end billing challenges, billing discrepancies, insurance follow-ups, and all contracted payment accounts. The responsibilities encompass all professional and hospital services performed or billed through Penn Medicine. The specialist will conduct daily charge reconciliations and ensure timely posting of services to the appropriate departments, maintaining high charge integrity, expected charge lag, and enhancing reimbursement while minimizing denials.

  • Utilize health system and external tools to monitor charges and edits, ensuring prompt and accurate reimbursement for services rendered.
  • Assist front office personnel in resolving patient-related issues.
  • Provide accurate self-pay rate quotes to patients as per entity guidelines.
  • Input charges and/or corrections into the relevant systems, resolving all pre-billing edits and reconciling charge reports within two business days.
  • Collaborate with other teams to proactively identify and address issues or variances in expected volumes.
  • Engage directly with the leadership team to meet the strategic and operational goals of the department.
  • Support departmental leadership in maintaining a high level of charge data integrity.
Qualifications:
  • Preferred: American Association of Healthcare Administrative Management certification.
  • Preferred: Revenue Cycle Certification.
Education and Experience:
  • High School Diploma/GED (Required).
  • Minimum of 3 years in a Hospital or Practice Revenue Cycle environment, with experience in working with insurance carriers and medical billing.
  • Bachelor's degree in Arts or Science with at least 2 years in a Hospital or Practice Revenue Cycle setting, focusing on insurance carriers and medical billing. Specialization in Healthcare, Finance, Management, or related fields is preferred.

Penn Medicine believes that exceptional patient care begins with exceptional employee care. Our comprehensive benefits programs are designed to promote health and well-being among our employees. We offer a competitive compensation and benefits package, including one of the finest prepaid tuition assistance programs in the region. Our employees are actively engaged and dedicated to our mission, working together to advance medical innovations that enhance lives.

We are an Equal Opportunity and Affirmative Action employer. All candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran, or any other status protected by applicable law.