Revenue Integrity Analyst
5 days ago
Summary
Revenue integrity professionals create value in clinical areas through revenue recovery and claim acceleration. This role requires extensive knowledge of Medicare Integrated Outpatient Code Editor (I/OCE) associated with Healthcare Common Procedure Coding System (HCPCS), Ambulatory Payment Classification (APC), HCPCS Modifier, and quarterly Revenue Code updates. The position is responsible for ensuring the integrity of charging and billing practices for healthcare services compliance with federal and state regulations.
Responsibilities
- Work with various departments to implement workflows and maintain accurate charge processes, achieving financial goals.
- Jointly manage account and claim edit work queues, coordinating with administrative and clinical operations staff to ensure correct coding and billing.
- Act as a liaison for clinical charging and financial areas regarding coding and charge capture compliance based on regulatory guidelines.
- Review patient medical records for charge capture and resolve billing edits, validating missing charges with clinical documentation.
- Demonstrate Service First characteristics and identify opportunities for improvement to enhance service and customer satisfaction.
- Perform related responsibilities as required.
Requirements, Preferences and Experience
Experience
- Minimum 3 years in healthcare with knowledge of revenue cycle functions.
- Preferred 6 years in a similar role.
Education
- Associate Degree or equivalent experience.
- Preferred Bachelor's degree in Health Information Management or Nursing.
Training
- Working knowledge of current Medicare, Medicaid, and regulatory IPPS/OPPS guidelines.
- Familiarity with applications and Microsoft Office products, especially Excel.
About Baptist Memorial Health Care
Baptist Memorial Health Care offers competitive compensation and benefits, including paid vacation, education assistance, and service awards. Recognized for excellence in benefits, Baptist values technical expertise and compassion in its colleagues.
- Competitive salaries
- Paid vacation/time off
- Continuing education opportunities
- Generous retirement plan
- Health insurance, including dental and vision
- Sick leave
- Service awards
- Free parking
- Short-term disability
- Life insurance
- Healthcare and dependent care spending accounts
- Employee referral program
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