Revenue Integrity/Authorization Specialist

Revenue Integrity / Authorization Specialist reconciles and posts all payments received, identifies discrepancies and analyzes issues to ensure payments are posted timely. Authorizes procedures with insurance providers. Full time. Weekday hours.

Essential Functions:

• Responsible for reviewing and maintaining charge description master (CDM), and/or other pertinent regulations and policies, ensuring all data elements are accurate and comply with all payor requirements.
• Provides education regarding documentation requirements to improve coding quality and ensure accurate and complete capture of maximum revenue.
• Reviews and interprets various regulatory billing and coding updates, to remain compliant and accurate and to minimize misbillings.
• Resolves issues that arise from information submitted and revenue cycle issues.
• Provides validation reviews, audits, documentation and training for the area of knowledge, sharing information with Finance, Medical Records and other revenue producing areas or departments.
• Pre-admits patients by phone or in person, gathering all necessary personal and financial information, working with physician office to make sure the process is effiecien and complete as possible.
• Assures that all pre-certifications and benefit information is completed on all applicable accounts.
• Schedules procedures and cases. Coordinates to ensure pre-authorization and insurance verificaion.
• Provides physician billing support by adding and removing charges on a monthly basis

Ashley Regional Medical Center is a Joint Commission accredited 39-bed hospital that is committed to serving our growing community with the highest quality services. Ashley Regional Medical Center has been named one of the top 100 Rural Hospitals in America for nine consecutive years.

Located in Vernal, Utah, known as an outdoor paradise. From Flaming Gorge Reservoir to the primitive areas of the Uinta Mountains, outdoor recreation is at your doorstep. Fishing, hunting, biking, camping, golfing, water sports, cross country skiing, white water rafting are just a few of the activities that this diverse landscape has to offer. All of this centrally located between Salt Lake and Denver.

• Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
• Competitive Paid Time Off / Extended Illness Bank package for full-time employees
• Employee Wellbeing Program – mental, physical, and financial wellness assistance
• Tuition Reimbursement/Assistance for qualified applicants

• Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
• Requires strong computer and internet research skills. Requires flexiblity, excellent interpersonal skills, project coordination expereince and the ability to work well with staff, leadershio. clients and vendors
• Prior related experience preferred.

EEOC Statement:
Ashley Regional Medical Center is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state law.