OSF Healthcare Careers

Revenue Integrity Specialist - PAT001466

Hours per week: 40
Status (Benefits): Full-Time
Work Schedule: 8:00-4:30
Location: 7915 N Hale Ave, Peoria, IL, United States

7915 N Hale Ave, Peoria, IL, United States

Job Description

Description

The Revenue Integrity Specialist is responsible for monitoring regulatory compliance as related to the charge master, identifying and resolving claim edits related to coding and or charges, identifying opportunities to strengthen charge capture processes, and facilitate appropriate revenue capture for services rendered. Responsible for the ongoing analysis and review of accuracy of the Charge Description Master (CDM). Interacts with internal departments and serves as a contact for coding expertise as related to the charge master. Researches coding and revenue reporting requirements and utilizes pricing applications to optimize reimbursement.

Qualifications

REQUIRED QUALIFICATIONS:

 

Must obtain one of the following:

Bachelor’s degree in Health Information Management or similar field

3 years’ acute care coding inpatient and outpatient experience

3 years’ extensive CPT experience with knowledge in medical terminology, anatomy and physiology, and disease processes.

 

 

Extensive ICD-10-CM, CPT/HCPCS and modifier knowledge.

 

Understand the overall functions and activities of hospital services and charging/coding practices.

 

Must be able to review legal and regulatory language with reasonable clarity, and be able to communicate the principles contained therein to others. 

 

Ability to understand and analyze payer regulations and how they impact the Charge master, reimbursement, and CDM coding.  

 

Ability to research complex coding and regulatory requirements.

 

Strong analytical skills. Ability to analyze financial data. 

 

Must possess solid analytical and interpersonal skills, be result oriented, provide definitive answers and meet deadlines.

 

Must maintain high productivity and quality with minimal supervision and possess ability to plan, organize, and implement complex process changes.

 

Ability to use Microsoft Office Programs, including but not limited to: Excel and Word.

 

 

PREFERRED QUALIFICATIONS:

 

Bachelor’s degree in Health Information Management or similar field

 

Previous experience in hospital medical records, finance, or clinical operations preferred.

 

Knowledge of UB Revenue Codes, various data elements associated with the hospital UB form and HCFA-1500 claim form, local and national coverage determinations, and various reimbursement methodologies.

 

Knowledge of EPIC.

 

 

Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS)

 

 

 

 

 

EOE/Minorities/Females/Vet/Disabled

Job seekers will be afforded equal opportunity regardless of their race, ethnicity, veteran status or disability status.

 

Experience the OSF culture and community by clicking here.

 

 

 

Job seekers will be afforded equal opportunity regardless of their race, ethnicity, veteran status or disability status.

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