Xtensys
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Revenue Integrity Specialist
role at
Xtensys
3 days ago Be among the first 25 applicants
About Us Xtensys, a recently established managed service provider, delivers cutting-edge technology to health systems, starting in NY and expanding beyond. Owned by two industry leaders focused on innovation in rural and community health, we are rapidly growing with several major initiatives underway.
Job Summary The Revenue Integrity Specialist is responsible for performing and implementing charge capture and process improvement initiatives to optimize performance and improve revenue management. This position will also manage charge edits, conduct root cause analysis, develop corrective action plans, educate internal customers, and monitor results. The role will collaborate with the entire Revenue Integrity Team to operationalize the client’s Revenue Integrity strategy and plan for improving revenue results across all departments.
Duties/Responsibilities
Act as subject matter expert for all questions concerning charging and charge reconciliation.
Determine and execute the best approach for timely resolution of accounts with edits.
Ensure accuracy and compliance of accounts in terms of charge edits.
Maintain a working knowledge of institutional and professional claim forms.
Enter appropriate information into patient accounting system to ensure accurate account documentation.
Keep current knowledge of Federal, State and Managed Care billing methodologies, rules and regulations.
Understand hospital charge capture process and compliance issues and provide resolution by performing research, utilizing third party payor regulations, referencing billing guidelines and CMS guidelines.
Identify root cause of issues related to charge edits and coordinate efforts with hospital departments to minimize recurring edits related to billing and registration.
Identify automation opportunities.
Meet performance, productivity and quality goals metrics.
Attend and participate in department staff meetings and other meetings as assigned.
Escalate issues and trends to Revenue Integrity Director.
Participate in special projects as assigned.
Required Skills/Abilities
Minimum of high school diploma/GED with 5 years of revenue cycle experience, 2 of them in a Revenue Integrity Role, or
Associate's degree with 2 years of Revenue Cycle Experience.
Experience
Minimum of five (5) years of billing, coding, or revenue cycle experience in an institutional setting.
Medical terminology with working knowledge of ICD-10, CPT and HCPCS codes.
Experience using Microsoft Office suite including Word and Excel.
Professional Coding or Billing experience is a plus.
Epic experience is a plus.
Licensure
Billing or coding certification preferred.
Physical Requirements
Lifting up to 20 pounds, standing or sitting for extended periods of time, as well as repetitive use of hands and fingers.
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Revenue Integrity Specialist
role at
Xtensys
3 days ago Be among the first 25 applicants
About Us Xtensys, a recently established managed service provider, delivers cutting-edge technology to health systems, starting in NY and expanding beyond. Owned by two industry leaders focused on innovation in rural and community health, we are rapidly growing with several major initiatives underway.
Job Summary The Revenue Integrity Specialist is responsible for performing and implementing charge capture and process improvement initiatives to optimize performance and improve revenue management. This position will also manage charge edits, conduct root cause analysis, develop corrective action plans, educate internal customers, and monitor results. The role will collaborate with the entire Revenue Integrity Team to operationalize the client’s Revenue Integrity strategy and plan for improving revenue results across all departments.
Duties/Responsibilities
Act as subject matter expert for all questions concerning charging and charge reconciliation.
Determine and execute the best approach for timely resolution of accounts with edits.
Ensure accuracy and compliance of accounts in terms of charge edits.
Maintain a working knowledge of institutional and professional claim forms.
Enter appropriate information into patient accounting system to ensure accurate account documentation.
Keep current knowledge of Federal, State and Managed Care billing methodologies, rules and regulations.
Understand hospital charge capture process and compliance issues and provide resolution by performing research, utilizing third party payor regulations, referencing billing guidelines and CMS guidelines.
Identify root cause of issues related to charge edits and coordinate efforts with hospital departments to minimize recurring edits related to billing and registration.
Identify automation opportunities.
Meet performance, productivity and quality goals metrics.
Attend and participate in department staff meetings and other meetings as assigned.
Escalate issues and trends to Revenue Integrity Director.
Participate in special projects as assigned.
Required Skills/Abilities
Minimum of high school diploma/GED with 5 years of revenue cycle experience, 2 of them in a Revenue Integrity Role, or
Associate's degree with 2 years of Revenue Cycle Experience.
Experience
Minimum of five (5) years of billing, coding, or revenue cycle experience in an institutional setting.
Medical terminology with working knowledge of ICD-10, CPT and HCPCS codes.
Experience using Microsoft Office suite including Word and Excel.
Professional Coding or Billing experience is a plus.
Epic experience is a plus.
Licensure
Billing or coding certification preferred.
Physical Requirements
Lifting up to 20 pounds, standing or sitting for extended periods of time, as well as repetitive use of hands and fingers.
#J-18808-Ljbffr