Revenue Integrity Educator II
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About The Position
This position works under minimal supervision to develop and conduct individual or group presentations on coding, billing, and compliance topics. The duties for this position will include but is not limited to the following: Revenue Cycle Management Support: Research coding, documentation and reimbursement inquiries submitted by physicians, clinical departments, or revenue cycle management to ensure compliance with specific payer and/or government regulations and optimum reimbursement. Prepares timely responses based on research outcome. Conduct quality assurance reviews to ensure coding and billing practices are accurate, compliant with regulations, and aligned with University policies and Revenue Cycle Management guidelines. New Provider Education: Conduct standardized education for new providers (physicians, advanced practice providers, and other professional practitioners) for Internal Medicine, Pediatrics, Emergency Medicine, Radiology, PM&, R, Neurology, Psychiatry. Perform pre-bill reviews of professional charges and follow up with new providers to ensure accurate coding and documentation practices. Performs post-onboarding pre-bill review of professional charges and follow-up with new providers to confirm understanding documentation requirements to promote billing compliance. Clinical Department Education: Develop and conduct individual or group physician education presentations on coding, billing compliance guidelines, audit findings or internal reporting. Develop comprehensive content for presentations, including key concepts, regulations, case studies and practical examples. Billing Compliance Reviews: Conduct documentation and billing compliance reviews to assess the adequacy of medical record documentation and appropriate use of procedure, modifier, and diagnosis codes. Summarize audit outcomes and provide education as needed.
