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Senior Revenue Integrity Specialist

2 months ago

Mechanicsville, Virginia, United States Revenue Integrity Full time
Job Summary

The Senior Revenue Integrity Specialist plays a critical role in ensuring Cardiovascular and Interventional Radiology (CVIR) services are charged and coded correctly. This position is a specialized senior medical coder in the Cath Lab, IR, and EP service lines.

Key Responsibilities
  • Assigns/Codes Charges CPCS/CPT Coding based on medical record documentation for Cath Lab/IR/EP service lines
  • Coordinates with facility/departments to obtain missing medical record documentation as needed
  • Coordinates with department leaders to identify trends and address issues related to charge capture
  • Ability to understand/apply National and Local Coverage Determination and educate facility departments routinely
  • Performs in-depth reviews and verifies the appropriateness of patient charges and Chargemaster (CDM) assignments
  • Supports the Revenue Integrity team by optimizing processes to ensure services rendered are accurately reported and reimbursed while maintaining compliance
  • Provides focused education to clinical and coding stakeholders as needed
  • Participates to ensure CDM/system updates result in appropriate reimbursement
  • Monitors any applicable Key Performance Indicators (KPIs) to identify new RI initiatives that are applicable to their assigned facility
Requirements
  • Associates Degree Required. Equivalent work experience may substitute education requirements.
  • Minimum 1 year coding/HIM experience
  • Minimum 3 years healthcare experience (hospital operations, clinical operations, etc.)
  • RHIA or RHIT or CPC or COC or CCS, or CIRCC certifications required (must obtain certification within one year of start date).