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Revenue Integrity Specialist

2 months ago

Melville, New York, United States Catholic Health Full time
{"Responsibilities": "

Key Responsibilities:

  • Provide guidance and communication on correct charge capture and billing processes to clinical departments and facilities.
  • Perform periodic reviews and assessments of charge capture for PRC departments.
  • Identify trends and participate in the resolution of revenue/charge-related issues.
  • Identify opportunities for capturing additional revenue in accordance with payer guidelines.
  • Develop specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.
  • Coordinate and assist with research and implementation of charge capture processes for new services and/or new/updated technology.
  • Work with Coding and clinical departments to identify/resolve errors based on ICD/CPT coding guidelines and National Correct Coding Initiative edits.
  • Respond to departmental charging inquiries in a timely manner.
  • Lead meetings to discuss charge capture findings.
  • Assist in developing revenue integrity training documentation and policies for training and education within the Revenue Integrity team and departments providing physician services.
  • Perform other duties as assigned.

Requirements and Qualifications:

  • Bachelor's degree in Healthcare or Business Administration, Finance, Accounting, Nursing, or a related field, or an equivalent combination of years of education and experience.
  • Proficient presenting to and interacting with all levels of ambulatory and hospital management.
  • Strong interpersonal skills to integrate and successfully function with all levels of the organization.
  • Extreme attention to detail, highly developed organizational skills, and ability to prioritize assignments.
  • Excellent communication skills: both verbally and in written text.
  • Superior analytical and problem-solving skills.
  • Self-directed with ability to work independently and manage time effectively.
  • Ability to identify and redesign inefficient workflows and processes; offer guidance and quality decisions.
  • Positive and professional attitude, with a strong emphasis on working as a team.
  • Perform quality work within deadlines.

Experience:

  • Three (3) or more years of experience in charge documentation, charge audit, or charge capture activities.
  • Proficient knowledge of ICD/CPT coding required; CPC or CCS-P required.
  • Strong computer literacy required, including proficiency in relevant software, including Microsoft Office (Excel, PowerPoint, and Word; Access a plus).
  • Epic HB/PB experience preferred.
  • Related Epic certification and/or Epic proficiency preferred.

Salary Range:

USD - USD per year.

This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate's qualifications, skills, competencies, and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits.

At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.