Revenue Integrity Specialist

About the role

The Revenue Integrity Specialist is responsible for documenting and supporting the charge capture practices for Renown Health System. The Specialist will support the data gathering for the review and maintenance of the hospital and professional chargemasters, charge documents, and charge capture processes. The Specialist will ensure that claim edits and work queues for Revenue Integrity are worked to resolution to ensure that claims are not held up from billing to maximizing organizational reimbursement. The specialist will perform data gathering for ROIs.

Responsibilities

• Track and trend data on late charges, provides weekly and monthly reporting to Renown Health leaders.
• Track and trend data on late charge root causes, providing weekly and monthly reporting to Revenue Cycle Leadership, as well as Revenue Integrity Coordinators for follow up with clinical departments.
• Keep an issue log of findings/issues/action plans for the work queues under the Specialist’s responsibility.
• Identifies, researches, and analyzes charging errors and/or omissions, working collaboratively with appropriate department staff/team members to ensure that revisions/corrections are made.
• May address routine system issues, referring to non‑routine matters to department leaders.
• Prepares reports, and provides departmental summary information to the health network which is responsible for ensuring that all charges on a system‑wide basis are being captured and charged appropriately.
• Assists interdepartmental teams in troubleshooting accounts that are being held for billing in edits due to charging/documentation discrepancies.
• Assists with management and maintenance of SNOW tickets.
• Interfaces with IT for maintenance tickets.
• This position does not involve direct patient care.

Requirements

• Ability to read, write, speak, and understand English sufficiently to perform job duties safely and effectively.
• Bachelor's Degree preferred.
• Medical terminology experience preferred.
• Two years in hospital revenue cycle with knowledge of charging practices preferred.
• Coding and claims edit experience required.

Skills

• Proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and Word.
• Ability to use the computer to complete online learning requirements for job‑specific competencies, access online forms and policies, complete online benefits enrollment, etc.
• Computer literacy including word processing, spreadsheet applications, database management, and Microsoft Access.