What are the responsibilities and job description for the Revenue Integrity Coordinator, Bentonville, Full-time position at Unity Health?
1. Education: Bachelor’s degree in Business or Health Administration preferred. Medical terminology preferred.
2. Training and Experience: Must be able to accurately type 25-30 words per minute. Must exhibit competency with Microsoft Office applications. Five (5) years minimum recent experience in the healthcare industry required.
3. Job Knowledge: Working knowledge of healthcare revenue cycle functions including coding and billing guidelines, government payer regulations and cost reporting. Must have revenue code and CPT coding knowledge. Working knowledge of multiple reimbursement systems including Prospective Payment System (PPS). Proficient skills to collect, organize and analyze data, produce reports and recommend improvements and solutions. Strong communication, teaching and presentation skills. Ability to interpret and implement regulatory standards.
4. Safety Sensitive: NO
In the interest of protecting the health and safety of all patients, associates, and guests, Unity Health has classified some positions as “safety sensitive.” A “safety sensitive” position is any job position in which impaired performance could result in harm to the health and/or safety of self or others. Any associate that is actively engaged in the use of medical marijuana, even if in possession of a valid medical marijuana card, will be excluded from employment in a “safety sensitive” position.
DESCRIPTION:
This Coordinator has the responsibility of interpreting government regulations and affecting process changes throughout UNIFIED MEDICAL EQUIPMENT SOLUTIONS to ensure compliance with these regulations. This position is responsible for the accuracy of the Charge Description Master (CDM) as designated by regulatory agencies and payers. Duties include analysis and verification of charging procedures, ensuring correctness of coding in the CDM and providing education to UNIFIED MEDICAL EQUIPMENT SOLUTIONS management in the accuracy of charges. This position is responsible for the analysis and assessment of diverse data relating to the revenue cycle. This requires extensive knowledge of all aspects of the revenue cycle, including the registration, coding, billing and collection processes, as well as government and payer regulations. Acting as an internal consultant, this Coordinator provides essential quality evaluation, reports, advice and improvement recommendations to management in all service lines. The Revenue Integrity Coordinator is required to understand and communicate complex issues and changes relating to regulatory compliance and third-party reimbursement to the department(s) involved, maintaining records of their notification, accountability and compliance. This position is responsible for assessment of individual and departmental compliance issues and reporting any non-compliance through UNITY HEALTH Service Line structures. This position works closely with Patient Financial Services staff and UNITY HEALTH Service Line management staff to provide accurate, critical information for identification of areas needing immediate attention to expedite compliance, recommend revenue cycle process improvements and collect every dollar owed. This position is responsible for the development and execution of training and quality assurance programs for all Patient Financial Services and other revenue cycle functions as assigned.
A Revenue Integrity Coordinator is highly skilled and works at a fully cross-functional level. This employee has a working knowledge of all functional areas for UNITY HEALTH Revenue Cycle performance including:
• Patient Registration
• Pre-Encounter Processing
• Financial Screening and Counseling
• Front-End Collections
• Regulatory Compliance • Charge Capture and Protection
• Billing and Claim Submission
• Third-Party and Guarantor Follow-up
• Cashiering, Refunds and Adjustments
• Denial Management and Avoidance
• Customer Service
• Health Information Management Coding
• Health Information Management Medical Necessity • Reimbursement and Cost Reporting
• Federal Recovery Audits
• State Recovery Audits
• Commercial Payer Audits
Physical Effort: Sitting 3-4 hours; standing 3-4 hours; walking 3-4 hours. Moderate lifting of 20-25 pounds, 1-10 times per day. Moderate bending, squatting and kneeling. Frequent fine motor movement with both hands. Manual dexterity to utilize computer. Good visual and hearing discrimination. Moderate lack of control over pace of work and high level of interaction with patients and employees throughout the work day.
Mental Effort:
a. Strong Oral Communications skills
b. Strong written communications skills
c. Strong Organizational Skills
d. Logical thinking, ability to break down processes
e. Strong Computation skills
f. Data oriented
g. Good people skills; able to teach to the individual
