What are the responsibilities and job description for the Revenue Integrity Specialist position at Raleigh General Hospital?
Raleigh General Hospital
Who We Are:
People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Raleigh General Hospital is a 300 bed facility caring for nearly 13,000 patients each year with over 50,000 being treated in our emergency room. We offer a wide range of surgical services as well as specialty programs including Cardiac CTA, Digital Mammography, and Trauma Services.
Where We Are:
Beckley is an ideal place to live and boasts many scenic, cultural, and recreational opportunities. From restaurants and breweries to art galleries and unique attractions, Beckley is an outdoor playground with something for all tastes.
Why Choose Us:
- Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
- Competitive Paid Time Off / Extended Illness Bank package for full-time employees
- Employee Assistance Program – mental, physical, and financial wellness assistance
- Educational assistance and tuition assistance for qualified applicants
- Professional development opportunities and CE assistance
- And much more…
Oversee corrections on accounts with any over/under charges noted during account review.
Work in coordination with the Revenue Integrity Compliance Director in collaboration with ancillary department managers to improve accuracy of billing compliance and assist with process improvement initiatives to reduce re-work and cycle time from service to billing time.
Monitor reimbursement problem areas and work with staff to resolve problems and optimize reimbursement and/or profitability.
Ensure accurate billing to maximize reimbursements, billing/coding compliance, minimize delays in the business operations cycle.
ESSENTIAL FUNCTIONS
Performs audits of charge-based accounts and works independently.
Review and work OCE edits on Bill 49 and DET.
Works closely with Department Managers to identify trends and charging issues.
Schedules and conducts charge audit meeting.
Processes late charges daily.
Maintains Chargemaster
Follows compliance policies and reports potential compliance/ethical concerns to Director.
JOB REQUIREMENTS
Minimum Education
High school diploma or equivalent Required
Required Skills
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.
Licenses:
Minimum Work Experience
Minimum two years previous medical billing/coding or compliance experience required. Familiarity with APC payment structure, UB-04 claim forms and CMS compliance guidelines preferred.
Meditech and patient account experience preferred. Previous computer experience required.
EEOC Statement:
Raleigh General Hospital 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 or local law.
Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran
