Revenue Integrity Specialist Hybrid
About the position As a Revenue Integrity Specialist, your primary duties are to provide subject matter expertise, operational support, and education related to coding, billing, & documentation. You will have ongoing daily operational tasks as well as project work that supports continuous process improvement efforts related to revenue cycle efficiency and compliance for St. Joseph Regional Medical Center. You will work under the direction of the Revenue Integrity [Cycle] Director and in collaboration with multiple departments within St. Joseph Regional Medical Center, Scion Health, community partners, and revenue cycle vendors. You play a crucial role in identifying opportunities for improvement, facilitating problem-solving, implementing action plans, and developing/improving workflows. The Revenue Integrity Specialist acts as a liaison and facilitator between stakeholders, while providing excellent customer service to both internal and external customers reflective of our Values, and in support of our Mission and Vision. Responsibilities • Work collaboratively with patient care departments & support departments to improve revenue cycle performance. • Provide education & training to physicians, non-physician practitioners, and staff. • Analyze data to identify opportunities for improvement and/or to validate processes and workflows are effective. • Summarize findings and when needed, make recommendations for solutions to prevent the recurrence of errors. • Lead and/or support various process improvement initiatives as requested. • Maintain current knowledge of billing & coding guidelines. • Maintain current knowledge of payment methodologies and regulatory guidelines impacting revenue cycle. • Perform job functions within applicable state & federal guidelines. • Navigate within electronic medical record systems, payer systems, and revenue cycle vendor applications. • Assist in creating internal resources and quick references (i.e. topic-specific regulatory guidance, payer coverage policies, workflow process maps, workflow checklists, etc.) • Perform all duties in a manner that protects the confidentiality of patients. • Maintain a clean, professional, and organized workspace, including electronic systems. • Complete all mandated training/education promptly and completely upon hire and as required thereafter. • Other assigned duties that support departmental and/or organizational objectives. Requirements • High school diploma or equivalent. • Minimum of 5 years working in a revenue cycle role where medical coding was a significant portion of your job. • Minimum of 2 years working in a revenue cycle role where medical billing was a significant portion of your job. • Active medical coding certification from an accredited organization required. • Advanced working knowledge of ICD-10, CPT, and HCPC guidelines. • Advanced knowledge of CMS regulations and resources available. • Working knowledge of commercial payer, government payer, workers compensation, and liability insurance guidelines. • Intermediate proficiency in Microsoft Outlook, Microsoft Word, and Microsoft Excel. • Advanced proficiency in navigating electronic computer systems and payer websites. • Ability to communicate and work effectively with the public, community partners, and co-workers. • Ability to manage job tasks, time, and resources appropriately. Nice-to-haves • Experience working on revenue cycle improvement initiatives. • Experience working in multiple areas within revenue cycle and/or other revenue generating departments. Apply tot his job