Revenue Integrity Specialist

Durham, NC - USA

Monthly Salary: Not Disclosed

Posted on: Yesterday

Vacancies: 1 Vacancy

Job Summary

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.

Required Experience:

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

Required Experience: