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Revenue Cycle Specialist
2 months ago
Job Summary:
This position is responsible for reviewing and auditing charge capture at the department level, completing charge reconciliation, analyzing and resolving claims' denials and unbilled claims' issues, performing audits on department patient accounts, supporting Revenue Integrity initiatives on behalf of the department, and ensuring billing compliance.
Key Responsibilities:
- Reviews and audits departmental charge capture, performs charge reconciliation on a regular basis, and works closely with department staff on timely charge capture.
- Performs timely reviews of patient accounts and remittances for denials in order to determine root cause and appropriateness, and leads corrective action plans.
- Analyzes and resolves claims' denials and unbilled claims, including posting debits and credits to patient accounts.
- Facilitates selection of patient encounters for review prior to and after patient billing for purposes of performing audits and verification of billing compliance.
- Performs various analysis and provides reports to determine trends, compliant billing, impact on net revenue, and other analytical requests pertaining to revenue cycle.
- Works in concert with Revenue Management Team members and Revenue Integrity team at the hospital to ensure timely gathering and reporting of applicable data Interacts and works with Revenue Cycle departments (i.e. HIM, Patient Access, PFS, and Compliance) on revenue management initiatives and process improvement opportunities.
Requirements:
- High School Diploma
Work Type:
Full Time
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