Revenue Integrity Specialist (Hybrid) Day Shift, Revenue Integrity

Adventist HealthCare•Gaithersburg, MD

8d•$26 - $36•Hybrid

About The Position

Adventist HealthCare seeks to hire an experienced Revenue Integrity Specialist who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing. As a Revenue Integrity Specialist, you will: • Assigned work queues and associated tasks to review, analyze, and provide corrective action. • Keep work queues at agreed-upon levels to keep on task with department goals and objectives • Escalate any barriers or concerns to the manager in a timely, clearly articulated, and documented format • Perform EHR analysis and research along with associated patient accounting, medical charting, and system interfacing to examine and understand underlying root causes of charge capture delays and reconciliation challenges • Build & maintain relationships with key stakeholders covering a range of business sectors. • Provide support to the Director, Manager, and Coordinators in their efforts to collaborate with AHC entities, physicians, physician practices, CMOs, CDI, and other stakeholders in understanding the impact of coding on care quality, documentation, and reimbursement. • Serves as auditing SME for Revenue Integrity • Provide input to the coding team, including coding auditors and coding vendor as needed. • QAQC role works with key contacts, dashboards, and reports to reconcile charges according to the source information and against visits and other visit data • Work to ensure charges are entered timely and escalate any barriers to charge capture or reconciliation • Review and support policies and procedures on Charge Capture and Reconciliation • Run reports and respond to requests for detailed analysis, responses, and recommended corrective action. • Focus reporting on AHC denials, rejections, and holds to determine patterns and trends and support corrective action needed

Requirements

5 years of experience in quality review and comparable position
High School Diploma required
Strong experience with patient accounts, audits, and accuracy is required.
Good organizational, written, and verbal communication skills
Ability to perform comfortably in a fast-paced, deadline-oriented work environment.
Ability to work as an independent contributor.
Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel; fluency in Cerner and/or eCW is desirable.
Strong attention to detail and accuracy, using problem-solving skills and analytical thinking.

Nice To Haves

Associate Degree preferred
Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel; fluency in Cerner and/or eCW is desirable.

Responsibilities

Assigned work queues and associated tasks to review, analyze, and provide corrective action.
Keep work queues at agreed-upon levels to keep on task with department goals and objectives
Escalate any barriers or concerns to the manager in a timely, clearly articulated, and documented format
Perform EHR analysis and research along with associated patient accounting, medical charting, and system interfacing to examine and understand underlying root causes of charge capture delays and reconciliation challenges
Build & maintain relationships with key stakeholders covering a range of business sectors.
Provide support to the Director, Manager, and Coordinators in their efforts to collaborate with AHC entities, physicians, physician practices, CMOs, CDI, and other stakeholders in understanding the impact of coding on care quality, documentation, and reimbursement.
Serves as auditing SME for Revenue Integrity
Provide input to the coding team, including coding auditors and coding vendor as needed.
QAQC role works with key contacts, dashboards, and reports to reconcile charges according to the source information and against visits and other visit data
Work to ensure charges are entered timely and escalate any barriers to charge capture or reconciliation
Review and support policies and procedures on Charge Capture and Reconciliation
Run reports and respond to requests for detailed analysis, responses, and recommended corrective action.
Focus reporting on AHC denials, rejections, and holds to determine patterns and trends and support corrective action needed

Benefits

Work life balance through nonrotating shifts
Recognition and rewards for professional expertise
Free Employee parking
Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire
Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available)
Paid Time Off
Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period
Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care, and critical illness & accident insurance
Subsidized childcare at participating childcare centers
Tuition Reimbursement
Employee Assistance Program (EAP) support