Revenue Integrity Specialist
Position Title: Revenue Integrity Specialist
Location: 1900 N SUNRISE DR, USA, Saint Peter, MN, 56082
Base Pay: 20.58 - 28.03 / Hour
Description: Description
Responsibilities
• Complete Excellian work queues daily, as assigned.
• Research all information needed to submit authorization requests for inpatient and outpatient surgical services.
• Work with payers on notification for inpatients, observation patients, and discharges.
• Process and post receipts and insurance payments.
• Prorate patient accounts following insurance payments.
• Distribute insurance denials or requests to OS Inc.
• Scan insurance remits and adjustment requests not located in clearinghouse.
• With OS Inc, review Accounts Receivable Credit Balance report and refund over payments to appropriate party, as appropriate.
• With OS Inc, edit HCFA 1500 and UB92 claims for transmission to insurance.
• Utilize Internet & portals for payer information and stay current with updates. Notify HIM, Central Scheduling, and OS Inc, as appropriate.
• Attend seminars.
• Complete incoming correspondence daily.
• Answer incoming calls and assist Patient Account Rep with billing issues.
• Maintain strictest confidentiality.
• Perform other duties as assigned by Patient Financial Services Manager.
• Adhere to hospital policy.
• Provide excellent customer service to patients and staff.
• Provide good communication and work effectively with co-workers and other departments.
• Ensure that River's Edge Hospital billing practices are in compliance with government laws and CMS regulations.
• Other Duties
• Maintain working knowledge of facility fire and disaster plans, accurately and efficiently perform duties in the event of drills and related actual situations.
• Maintain confidentiality of patient, physician and employee information.
• Participate in facility committees and work teams as appropriate.
• Assist in the orientation and training of new employees and/or students.
• Complete special projects and perform other related duties, as assigned.
Requirements:
• High School diploma or GED with degree in Medical Billing, preferred
• Three years combined of medical billing and accounts receivable experience, preferred
• Knowledge of hospital billing practices, policies, and procedures
• Knowledge of insurance related to reimbursement procedures and practices
• Ability to prepare records in accordance with detailed instructions and examine documents for accuracy
• Experience obtaining Prior Authorizations and Inpatient Notifications
• Ability to prepare claims for accurate reimbursement and to meet deadlines
• Preferred experience with Excellian/Epic Resolute patient accounting system
• Excellent skills in oral and written communication
• Ability to work effectively with patients and co-workers
• Possess strong customer service skills
Business Content
Accounting/Auditing and Finance
Full-time