Healthcare Revenue Assurance Specialist

2 weeks ago

Philadelphia, Pennsylvania, United States Pennsylvania Medicine Full time

Penn Medicine is committed to our mission of delivering exceptional patient care, pioneering research, and training the next generation of medical professionals. Joining our esteemed academic medical center means collaborating with leading experts across various fields.

At Penn Medicine, every day presents an opportunity for breakthroughs—whether it's healing patients, delivering positive news, or providing comfort. Our workforce plays a crucial role in shaping the future of healthcare. Are you ready to contribute to this mission?

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

Role 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 (diagnostic, therapeutic, or surgical) billed through Penn Medicine. The position entails daily charge reconciliation and ensuring timely posting of services to the correct department. Collaboration with various departments is key to maintaining charge integrity, minimizing charge lag, enhancing reimbursement, and reducing denials.

  • Leverage health system and external tools to track charges and edits, ensuring prompt and precise reimbursement for services rendered.
  • Assist front office personnel in resolving patient-related issues.
  • Provide accurate self-pay rate quotes to patients in accordance with entity guidelines.
  • Input charges and/or corrections into the relevant system, resolving all pre-billing edits and reconciling charge reports within two business days.
  • Collaborate closely with other teams to proactively identify and address issues or discrepancies in expected volumes.
  • Engage directly with the leadership team to fulfill the strategic and operational goals of the department.
  • Support departmental leadership in upholding a high standard 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, working with insurance providers and medical billing.
  • Bachelor's degree in Arts or Science and at least 2 years in a Hospital or Practice Revenue Cycle environment, working with insurance providers and medical billing. Specialization in Healthcare, Finance, Management, or a related field is preferred.

We believe 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 dedicated to our mission, and together we will continue to advance medical science to help individuals lead longer, healthier lives.

Live Your Life's Work

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.

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