What are the responsibilities and job description for the Revenue Integrity Specialist position at Surgery Partners Brand?
North Carolina Specialty Hospital (NCSH) is a private, physician-owned medical center that opened its doors in 1926. Its commitment to growth and continuous improvement has helped the hospital maintain a high ranking in both quality measures and patient satisfaction. North Carolina Specialty Hospital offers surgical specialties in orthopedics, ophthalmology, ear, nose, and throat, as well as sports medicine, oral, plastic, podiatry, general surgery, interventional radiology, pain management, reconstructive surgery, and more.
Why join North Carolina Specialty Hospital?
- Award Winning Hospital for Special Surgery
- 5 Star CMS rated facility for patient experience
- Positive Work culture
- Career growth opportunities
- Comprehensive Medical, Dental, Vision Insurance, Life and Disability Insurance
- Paid Time Off
- 401k Employer Match
- Tuition Assistance
Key responsibilities
- Medical coding: Translating patient diagnoses and procedures from medical records into standardized codes (like ICD-10 and CPT).
- Prior authorization: Work with various departments such as scheduling, admitting, UR, and the business office regarding authorizations.
- Documentation: Verifying that all required information is present and accurate to support the authorization request for scheduled cases.
- Communication: Interacting with providers, patients, and insurance companies to manage the authorization process to reduce authorization denials.
- Compliance: Ensuring all coding and authorization processes comply with industry standards and regulations.
Relevant certifications
- Certified Coding Specialist (CCS): A national certification from the American Health Information Management Association (AHIMA) for those skilled in classifying medical data, often for inpatient settings like hospitals.
Necessary skills and knowledge
- Proficiency with medical coding systems, such as ICD-10, CPT, and HCPCS.
- A strong understanding of medical billing and insurance processes.
- The ability to effectively manage the entire authorization process from initiation to approval or denial.
- Experience with specific systems and the development of efficient routines for processing requests.
- Certified Coding Specialist (CCS) - AHIMA
Our employees are critical to our success and we value their contributions. North Carolina Specialty Hospital offers a competitive compensation and benefits package and an opportunity to grow and develop your career in an environment that values employee ideas and diversity. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled. We maintain a drug-free workplace and require pre-employment drug screening and background check.