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Healthcare Revenue Integrity Specialist

2 months ago

Camden, New Jersey, United States Insight Global Full time
Position Overview

Insight Global is seeking a Revenue Integrity Analyst to support a prominent healthcare organization. This role is pivotal in ensuring the accuracy and compliance of the charge reconciliation process.

Key Responsibilities
  • Oversee the charge reconciliation process and ensure all aspects of revenue integrity are maintained.
  • Collaborate with the Manager of Revenue Integrity and CDM Analysts to address revenue integrity for designated departments and cost centers.
  • Manage charge-related claim edits and conduct Revenue Guardian checks across various work queues.
  • Supervise EPIC Charge Review Work Queues and liaise with PB and HB Denial teams to analyze and rectify denials and edits.
  • Facilitate end-user training for Craneware, monitor requests, and gather necessary information.
Work Environment

This position requires an onsite presence five days a week for the initial period, transitioning to a hybrid schedule thereafter.

Diversity and Inclusion

We are dedicated to fostering diverse and inclusive workplaces where every individual can express their authentic selves. Insight Global is an equal opportunity employer, and we encourage applications from all qualified candidates.

Qualifications
  • Experience with Epic and Business Intelligence tools.
  • Relevant coding certifications (CPC, COC, CPC-H, CCS).
  • Understanding of supply chain and pharmacy processes.
  • Bachelor's degree or equivalent experience.
  • Minimum of 5 years in healthcare, with knowledge of hospital operations and payment systems.
  • At least 3 years in auditing, coding, revenue integrity, or revenue cycle management.
  • Proficient in coding-related billing edits and knowledgeable about Medicare/Medicaid regulations.
  • Strong analytical skills with experience in data reporting tools such as Excel and Tableau.