| Department |
Finance - Patient Financial Services |
| Description |
Position Summary:
The Revenue Integrity Specialist will review OPPS claim edits to ensure compliance with CCI, OCE, MUE claim edits and LCD & NCD billing rules, while maximizing reimbursement. Works with Revenue Cycle leadership to ensure ongoing development, testing, implementation, maintenance and operational optimization of Epic’s Revenue Guardian module and/or other related claim editing software. Monitors trends in billing edits to identify needs for retraining and optimization of the build of editing tools to minimize manual intervention and maximize compliance. Works through Revenue Cycle leadership to communicate training and optimization needs to clinical leadership, chargemaster committee, compliance, and related areas.
Minimum Qualifications:
- High school diploma or equivalent.
- Two (2) years of hospital revenue cycle experience with a specific understanding of APC payment structures and other third party payment methodologies.
Please click on the link below to open and review the detailed job description and minimum qualifications:
Revenue Integrity Specialist
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- Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.
- Please view Equal Employment Opportunity Posters provided by OFCCP
here.
- The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
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