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Revenue Integrity Department Specialist

Facility: CHS Services Inc Location: Melville, NY Department: Physician Revenue Realization Category: Administrative / Business Support Schedule: Full Time Shift: Day shift Hours: 8:00am-4:00pm ReqNum: 6029116

Revenue Integrity Department Specialist

The responsibility of this position is to serve as the revenue liaison between the revenue cycle management departments, the hospital and ambulatory departments, and any physician/provider area that generates revenue for the professional component. This position is responsible for collaborating with department revenue leads and staff to ensure accurate charge capture operations are in place to include daily charge capture, revenue reconciliation and error correction processes.

DUTIES/RESPONSIBILITIES:

  • Provides guidance and communication on correct charge capture and billing processes to clinical department and facilities.
  • Perform periodic reviews and assessments of charge capture for PRC Departments.
  • Identifies trends and participates in the resolution of revenue/charge related issues.
  • Identifies opportunities for capturing additional revenue in accordance with payer guidelines.
  • Develops specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.
  • Coordinates and assists with research and implementation of charge capture processes for new services and/or new/updated technology.
  • Works with Coding and clinical departments to identify/resolve errors based on ICD/CPT Coding Guidelines and National Correct Coding Initiative edits.
  • Responds to departmental charging inquiries timely.
  • Leads meetings to discuss charge capture findings.
  • Assists in developing revenue integrity training documentation and policies for training and education within the Revenue Integrity team and departments providing physician services.
  • Performs other duties as assigned.

POSITION REQUIREMENTS AND QUALIFICATIONS:

Education:

  • Bachelor's degree in Healthcare or Business Administration, Finance, Accounting, Nursing, or a related field, or an equivalent combination of years of education and experience.

Skills:

  • Proficient presenting to and interacting with all levels of ambulatory and hospital management.
  • Possess strong interpersonal skills in order to integrate and successfully function with all levels of the organization.
  • Extreme attention to detail, highly developed organizational skills, and ability to prioritize assignments.
  • Excellent communication skills: both verbally and in written text.
  • Superior analytical and problem solving skills.
  • Self-directed with ability to work independently and manage time effectively.
  • Ability to identify and redesign inefficient workflows and processes; offer guidance and quality decisions.
  • Positive and professional attitude, with a strong emphasis on working as a team.
  • Perform quality work within deadlines

Experience:

  • Three (3) or more years of experience in charge documentation, charge audit or charge capture activities.
  • Proficient knowledge of ICD/CPT coding required; CPC or CCS-P required.
  • Strong computer literacy required including proficiency in relevant software including, Microsoft Office (Excel, PowerPoint, and Word; Access a plus).
  • Epic HB/PB experience preferred.
  • Related Epic certification and/or Epic proficiency preferred
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  • Administrative / Business Support, Melville, New York, United StatesRemove