Revenue Integrity Specialist II

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What will you be doing in this role?

The Revenue Integrity Spec II, of Compliance and Revenue Integrity, is responsible for fact-finding, organization, and presentation of information in a manner that facilitates patient account management, revenue recognition and process improvement efforts. Serves as the single point of contact for all charging work queues issues and charge tickets. May perform recurring data compilations from varied sources to inform management team of work queue trends and late charge analysis, etc.

Under general direction of Health System Manager, may coordinate or monitor progress of special projects related to resolving identified late charge and/or revenue gaps or concerns. May require training of other CRI staff. May serve as co-administrator of the Epic HB charge review work queues that enables charge resolution. Ensures the timely completion of work assignments in accordance with established timelines. The Specialist:

- Performs accurate and timely coding charge posting (CPT, ICD-10, HCPCS, modifiers)

- Maintains familiarity with such issues as CMS coding regulations, Medicare rules, visits and procedures on the same day, consultation vs. referral, surgeries, etc.

- Understands and implements coding guidelines for multi-specialty practices.

- Attends seminars and workshops, as applicable, for updates on new coding rules and regulations.

- Elevates issues, as appropriate, to the Supervisor.

- Meets productivity and quality standards.

- Understands hospital coding trends by billing area, location, and provider.

- Identifies trends and issues with overall division and individual physician coding practices, as applicable.

- Follows policies and procedures pertinent to CRI & PFS Departments

- Handles all correspondence including (but limited to) documentation and files in a professional and confidential manner.

- Supports CSHS core values, policies, and procedures.

Originally posted on Himalayas