Revenue Integrity Specialist

Piedmont Healthcare • Atlanta, GA

1d

About The Position

Responsible for charge capture analysis, workflow and maintenance of related work queues in assigned service lines. Works designated work queues to resolve claim edits prior to billing by analyzing medical record documentation and application of payer guidelines. The position will evaluate and provide guidance related to billing and/or clearinghouse system edits. May complete focused charge review assessments for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes. Advise service line leaders and their staff on proper usage of charge codes; identify opportunities for capturing additional revenue in accordance with payer guidelines; develop specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.

Requirements

• 3 years of related healthcare experience focused in one or more of the following areas: charge integrity
• charge capture/reconciliation
• healthcare compliance
• charge auditing
• CDM management
• coding and/or hospital billing procedures
• Experience working with Epic
• AHIMA certification (e.g. RHIA, CCS, RHIT) Upon Hire
• RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure RN licensure Upon Hire
• certified healthcare provider (e.g. MT, RT) Upon Hire

Nice To Haves

• Associate’s Degree in HIM/HIT
• Bachelor’s Degree in HIM/HIT

Responsibilities

• Responsible for charge capture analysis, workflow and maintenance of related work queues in assigned service lines.
• Works designated work queues to resolve claim edits prior to billing by analyzing medical record documentation and application of payer guidelines.
• The position will evaluate and provide guidance related to billing and/or clearinghouse system edits.
• May complete focused charge review assessments for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes.
• Advise service line leaders and their staff on proper usage of charge codes; identify opportunities for capturing additional revenue in accordance with payer guidelines; develop specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED