[Remote] Revenue Integrity Specialist

Note: The job is a remote job and is open to candidates in USA. Scripps Health is a leading healthcare organization supporting multiple hospital campuses and outpatient centers. The Revenue Integrity Specialist role focuses on managing revenue capture processes and conducting assessments to ensure accurate billing and compliance with coding guidelines.ResponsibilitiesDaily management / resolution of revenue capture work queues (Account, Charge Review and Charge Router Review)Conducting quality and accuracy assessments of ancillary service area charge capture processes and clinical documentation for the care providedReview of the CPT/HCPCS codes associated with the procedural charges selected by the clinicians and codersValidation of the required documentation elements to support the services provided and chargedReview of the charge capture processes including applicable charge sheets for supplies, medications, implants, proceduresValidates accuracy and timeliness of charge entryProvides timely feedback to ancillary care providers on quality and accuracy assessmentEvaluate and monitor coded diagnosis, coded procedures, and charges following National Correct Coding Guidelines, Medicare Integrated Code Editor, medical necessity, and regulatory billing guidelinesIdentifies correct code and sequences the diagnoses and procedures using ICD-10-CM, CPT, HCPCS and modifier assigned on accountsSkillsHigh School graduate with completion of a certified coding program, or certified auditing program, or Associate's degree in health information technologyDemonstrates proficiency in use of ICD-10-CM, HCPCS, and CPT coding by successful completion of a written exam for outpatient Coder level IIProficient in preparation and presentation of summary reports, education, and training power point presentations to focused groups and finance leadershipMinimum of one of one year experience required in an acute care hospital outpatient codingMinimum of 1 year experience required in utilization of spreadsheets, graphics, power point, analytics and database applicationsMinimum of 1 year experience preferred in the performance of charge quality assessments in an acute care hospitalCertification/Registration: Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS), from American Health Information Management Association (AHIMA), or Certified Professional Coder (CPC) from American Academy of Professional Coders, or Certified Internal Auditor from Association of Healthcare Internal Auditors (AHIA), or Certified Medical Audit Specialist by American Association of Medical Audit Specialists (AAMAS)Epic experienceExperience with focus audits, reports and codingCompany OverviewScripps Health is a nonprofit health care system based in San Diego, California. It was founded in 1924, and is headquartered in San Diego, California, USA, with a workforce of 10001+ employees. Its website is http://www.scripps.org.



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