What are the responsibilities and job description for the REVENUE INTEGRITY SPECIALIST position at St. Bernards Healthcare?
JOB REQUIREMENTS
Education
College Graduate and/or 5 plus years’ experience with revenue cycle operations.
Experience
o Requires 2 - 5 years of healthcare experience preferably with knowledge of the reimbursement/denials process. Should have knowledge of ICD 10 & CPT coding and guidelines. Knowledge of reimbursement systems, Federal, State and payor-specific regulations pertaining to documentation and billing. Requires coding, billing (UB-04 requirements), possesses process management, leadership and interpersonal skills. Requires excellent written and verbal communication skills. Must be proficient in Excel spreadsheet, PowerPoint presentations, word processing and database applications. Must be able to act independently. Documented results in getting desired results. Must have meticulous follow-up skills. Must have had experience in working in a team environment.
Physical
This is a safety sensitive position. Please see the St. Bernards Substance Abuse Policy for further information.
Normal hospital environment. Close eye work and hearing within normal range. Oral communication. Operates computer, fax and copier. Long periods of sitting. Occasional walking, bending, and climbing. May lift, carry, push and pull up to 5 pounds.
JOB SUMMARY
Responsible for aggregating and trending denials information according to discrete OP denial codes and work within denial software. Also works with IP denials. Analyzes information, assigns follow-up responsibility. Works with clinical areas to decrease denials by coordinating monthly meetings with departments to discuss trends, opportunities, etc. Assists Revenue Integrity Coordinator with denials appeals. Close out each tracked denial (overturned or recouped). Overall works to increase revenue capture. Assists Revenue Integrity Coordinator with Medical Center denials process as needed. Facility resource for denials/appeal process and regulatory compliance, as it relates to these. Ability to manage competing priorities, multi-task with results oriented outcomes and work in a fast paced environment. This position is required to utilize independent judgment and critical thinking skills.
Salary.com Estimation for REVENUE INTEGRITY SPECIALIST in JONESBORO, AR
$62,344 to $80,229
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