What are the responsibilities and job description for the Revenue Integrity Specialist position at Pain Specialists of America LLC?
Job Description
Job Description
Description :
Pain Specialists of America ("PSA") is a Texas-based, multisite comprehensive pain management company that includes over 15 locations. We are seeking talented professionals who can support the business and help it achieve its strategic objectives.
The Revenue Integrity Analyst will play a critical role in optimizing financial performance. This position is responsible for ensuring the accuracy and efficiency of billing processes, coding practices, and revenue capture. The analyst will work closely with clinical, billing, and financial teams to identify opportunities for revenue enhancement, mitigate compliance risks, and ensure adherence to industry standards and regulations.
Key Responsibilities
Revenue Cycle Analysis :
Monitor and analyze revenue cycle performance, including charge capture, billing, coding, and reimbursement processes.
Identify areas of improvement within the revenue cycle to optimize financial outcomes.
Collaborate with clinical staff to ensure accurate and complete documentation that supports proper coding and billing.
Coding and Billing Compliance :
Review and audit medical records to ensure accurate and compliant coding according to CPT, ICD-10, and HCPCS standards.
Ensure that billing practices align with payer requirements, industry standards, and regulatory guidelines (e.g., Medicare, Medicaid).
Provide education and training to clinical and billing staff on proper documentation and coding practices.
Serve as a working coder in time of need or for coverage purposes.
Revenue Integrity :
Conduct regular audits of charge capture processes to ensure that all services provided are billed correctly and in a timely manner.
Analyze denial patterns and work with the billing team to implement corrective actions to reduce denials and increase reimbursement.
Develop and implement strategies to prevent revenue leakage and ensure accurate revenue recognition.
Reporting and Data Analysis :
Generate and analyze reports on key performance indicators (KPIs) related to revenue cycle management, such as days in A / R, denial rates, and net collection rates.
Present findings and recommendations to leadership to support strategic decision-making.
Use data analytics tools to identify trends and areas for improvement.
Compliance and Risk Management :
Stay up-to-date with changes in healthcare regulations, payer policies, and coding guidelines.
Conduct compliance audits to ensure adherence to relevant laws and regulations.
Work with legal and compliance teams to address any identified risks and implement corrective action plans.
Collaboration and Communication :
Serve as a liaison between the clinical, billing, and financial teams to facilitate effective communication and collaboration.
Participate in cross-functional meetings to discuss revenue cycle improvements and implement best practices.
Assist with the development and updating of policies and procedures related to revenue integrity.
Benefits
Medical, Dental, Vision Insurance
401k w / company match contribution
Paid Time Off
Short & Long-Term Disability
HSA (w / company match contribution), FSA
Life Insurance (company paid voluntary options)
10 Paid Holidays for the Year 2025
Employee Assistance Programs
Requirements :
Bachelor’s degree in Finance, Healthcare Administration, or a related field; advanced degree or certification (e.g., CPC, CPMA, RHIA) is preferred.
Minimum of 5-7 years of experience in revenue cycle management, billing, or coding, preferably in a pain management or specialty practice setting.
Strong knowledge of healthcare billing, coding, and reimbursement processes, including familiarity with CPT, ICD-10, and HCPCS coding systems.
Experience with healthcare compliance regulations, including HIPAA, Medicare, and Medicaid requirements.
Proficiency in revenue cycle management software, electronic health records (EHR), and data analysis tools.
Excellent analytical, problem-solving, and organizational skills.
Strong communication skills with the ability to present complex information clearly and effectively.
Ability to work independently and collaboratively in a fast-paced environment.
Working Conditions :
This position typically operates in fully remote environment.
Occasional travel may be required to attend training or meetings.
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