Revenue Integrity Specialist
Revenue Integrity Specialist
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Job Description
Overview
Revenue Cycle Integrity Specialist
Days Full-time. No weekends or Holidays
This position is open to remote/work from home with strong preference for candidates residing within the UPH geographies of Iowa Illinois & Wisconsin.
We are seeking a Revenue Cycle Integrity Specialist to join our team! This role is a key member of the Revenue Cycle Team reporting directly to the Manger of Revenue Integrity. This position is responsible for working work queues identifying trends and collaboratively working with departments to improve the revenue cycle performance within UnityPoint Health. This position requires strong decision-making ability around charging issues complex claims processing workflows and regulations that requires utilization of data coming from multiple resources. To evaluate charging and billing issues appropriately Specialists will need to understand the entire Revenue Cycle. This role will have ongoing interaction with leadership revenue cycle staff coding staff billing staff and IT teams.
This individual will focus on supporting continuous improvement in key revenue cycle functions including Registration Coding and Billing. The Specialist will maintain a good working relationship with all affiliates to ensure clear communication and a collaborative approach to implementing best practice processes.
Why UnityPoint Health
At UnityPoint Health you matter. Were proud to be recognized as a Top 150 Place to Work in Healthcare by Beckers Healthcare several years in a row for our commitment to our team members.
Our competitive Total Rewards program offers benefits options that align with your needs and priorities no matter what life stage youre in. Here are just a few:
- Expect paid time off parental leave 401K matching and an employee recognition program.
- Dental and health insurance paid holidays short and long-term disability and more. We even offer pet insurance for your four-legged family members.
- Early access to earned wages with Daily Pay tuition reimbursement to help further your career and adoption assistance to help you grow your family.
With a collective goal to champion a culture of belonging where everyone feels valued and respected we honor the ways people are unique and embrace what brings us together.
And we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience.
Find a fulfilling career and make a difference with UnityPoint Health.
Responsibilities
Revenue CycleSpecialist
- Resolve billing errors/editscharge review edits and claim editsincluding accounts with Stop Bills and DNBs to ensure all claims are filed in a timely manner.
- Responsible for decision making to improve and impact charge issues complex claims processing workflows and regulations
- Responsible for providing informationto leadershiptoidentifiedcharging issues within departmentsclaims issues repetitive errors and payer trends to expedite claims adjudication.
- Assists with analyzingdata to identifyopportunities for processimprovement.Assist with development ofreporting that will create accountability and drive change.
- Assists withcriticalRevenue Cycle projects bycollaboratingwith key stakeholders across UnityPoint Health.These projects affect business operations to a substantial degree.
- Interprets existing revenue cycle policies and operating practicestomake recommendations for improvements.
- Responsible for maintainingin-depth understanding of the entire revenue cycle.Responsible fortroubleshootingregistration coding andcorrect coding initiative (CCI)edits.
- Research and resolve charge review claim edit and denialin assignedworkques(WQ).
- Liaison for the billing officeteam members. Answering questionsand troubleshoot accountsas needed.
Performance Monitoring/Revenue Integrity
- Responsible for applying knowledge of revenue cycle principles to ensure accurate and compliant billing
- Assists with collection monitoring and analyzing data and gives feedback to management for recommendations to leadershipto drive better performance throughout the revenue cycle.
- Responsible for identifying reaching and analyzing billing errors or omissions fordifferenttypes of data that require tracking to improverevenue cycleperformance.
- Work withRevenue IntegrityAnalystsand Directorsto prioritizerecommendchanges.
- Identifiestraining opportunities and providestrainingas neededto improve operations.
Denials Management
- Workwithleadership and staff to identify and remediate denials through rules and EMR build.
- Assist withreports that track performance and are easy-to-interpret.
- Understandcomplex rulesand regulations governing insurance appeal activities trends etc. and make recommendations on system build to accommodate changes in these areas.
- Responsible forunderstanding of the entire revenue cycle and the factors that lead to denials and revenue loss.
Qualifications
Education
- H.S. diploma/GED required
- Bachelors degree in Healthcare Administration Business Mathematics or Computer Science preferred.
Experience
- 2 years of progressive experience in revenue cycle/medical billing
Knowledge/Skills/Abilities
- Strong skills including professionalism interpersonal skills ability to communicate effectively through written and verbal methods process improvement skills.
- Fluent with Epic and Microsoft office programs. Ability to manipulate large amounts of data.
- Demonstrated decision making as it relates to processing reconciling and ensuring the accuracy of revenue and charge activity.
- Knowledge of entire revenue cycle process
- Knowledge of medical terminology and coding
Required Experience:
Unclear Seniority
Employment Type
Full-Time
