Job Summary : The on-site Sr. Revenue Integrity Analyst reviews and revises accounts to achieve revenue enhancement and compliance. This position updates and reviews accounts to ensure accurate and complete charge capture and accurate, timely billing. The incumbent establishes and maintains a library of rule, regulations, policies and procedures of all governmental and commercial payors.
Responsibilities:
Qualifications/Requirements:
Experience: Minimum 8 plus years clinical experience in a hospital setting, preferably cardiology, radiology, surgery or utilization review , required. Previous revenue integrity experience, Excel and Electronic Medical Records experience preferred.
Education : Graduate of an accredited program (RN,MD,PA), degree in healthcare preferred. Bachelors degree or equivalent work experience (8 plus years) required.
Licenses / Certifications: Certified Professional Coder (CPC) or Certified Professional Coder-Hospital (CPC-H), preferred.
Other: Familiarity with medical record documentation standards and practices, health care insurance billing issues, and federal and state billing compliance issues for hospitals; knowledge of CPT-4 codes and ICD-9-CM codes is preferred.
Special Requirements: Requires travel to other WMCHealth Facilities....experience maintaining data within SDE databases Minimum 3 years of experience working in upstream oil & gas industry Minimum 5 years GIS experience using ESRI software (ArcGIS, ArcPro experience preferred) Functional knowledge of core GIS concepts such as coordinate...
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