Revenue Integrity Coordinator
2 days ago
We are seeking a highly skilled Denial Management & Revenue Integrity Specialist to join our team at Mercy. As a key member of our revenue cycle function, you will be responsible for analyzing denied claims, underpaid and nonpaid claims, and working with key stakeholders and payors to investigate the reason for denial and determine the appropriate course of action.
Key Responsibilities- Analyze denied claims, underpaid and nonpaid claims to identify trends and areas for improvement
- Work with key stakeholders and payors to investigate the reason for denial and determine the appropriate course of action
- Write formal appeals and escalate claims for clinical or business review as appropriate
- Develop and implement strategies to reduce denial rates and improve revenue integrity
- Collaborate with cross-functional teams to identify and address system issues and process improvements
- Associate's degree in healthcare-related field
- CCDS (ACDIS Certified Clinical Documentation Specialist), or CDIP (AHIMA Certified Documentation Improvement Practitioner. Registered Health Information Technician Certification (RHIT), or Certified Coding Specialist Certification (CCS), or CHC (Certified Healthcare Compliance) required
- 2 years of direct healthcare experience with demonstrated expertise in revenue cycle functions as it relates to billing, coding, denial management and third-party payer requirements
- Excellent critical thinking skills with the ability to quickly make decisive decisions from limited written and/or oral information
- Excellent communication skills with ability to express oneself in writing and orally
- Ability to plan and organize workflow in order to meet deadlines
- Ability to produce reports using multi-formats and software, i.e. Word, Excel
- Ability to present data findings/report to leadership as needed
- Associates or Bachelors degree in healthcare-related field
- CCDS (ACDIS Certified Clinical Documentation Specialist), or CDIP (AHIMA Certified Documentation Improvement Practitioner. Registered Health Information Technician Certification (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist Certification (CCS), or CHC (Certified Healthcare Compliance) required
- 5 years of direct healthcare experience within the revenue cycle function as it relates to billing, coding, denial management and third-party payers
At Mercy, we offer a comprehensive benefits package, including day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds. We are committed to providing a supportive community for our employees, with opportunities for professional growth and development.
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