Revenue Integrity Specialist
About The Position
Student Health Services is an ambulatory care facility providing medical services to Ohio State University students. Under the direct supervision of the Revenue Cycle Manager, the Revenue Integrity Specialist 1 supports revenue cycle management for the facility, which has more than 25 providers and a variety of ancillary services. The role reviews and analyzes clinical documentation and coding to support integrity and compliance in billing practices, including timely claims submission. It also extracts and analyzes revenue-cycle data related to areas such as charge capture, accounts receivable, bad debt, denials, and payer analysis. The specialist supports the development of policies and procedures for reviewing clinical documentation, coding, and charge capture, and coordinates and presents training to operational, clinical, or business office staff when appropriate.
Requirements
- Bachelor’s degree in HIMS or a related field, or an equivalent combination of education and experience.
- Thorough knowledge of CPT, ICD-9, and ICD-10 coding concepts.
- Familiarity with medical terminology.
- Strong working knowledge of Microsoft Word, Excel, Outlook, and the Internet.
Nice To Haves
- Experience working in a healthcare setting.
- Experience with PyraMed or other medical billing systems and a Student Information System (SIS).
- Experience in medical and pharmaceutical reimbursement within a multi-carrier environment.
- Excellent communication skills.
- Working knowledge of University policies and procedures.
Responsibilities
- Review and analyze clinical documentation and coding to ensure integrity and compliance in billing practices.
- Help ensure timely claims submission.
- Extract and analyze data affecting the revenue cycle, including charge capture, accounts receivable, bad debt, denials, and payer analysis.
- Support development of policies and procedures for reviewing clinical documentation, coding, and charge capture.
- Coordinate and present training to operational, clinical, or business office staff when appropriate.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
