Revenue Integrity Specialist

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. This position will review charge review, claim, and denial edits to ensure compliance with CCI, OCE, MUE claim edits and LCD & NCD billing rules, while maximizing reimbursement. Works with Revenue Cycle leadership to ensure ongoing development, testing, implementation, maintenance and operational optimization of Epic’s Revenue Guardian module and/or other related claim editing software. Monitors trends in billing edits to identify needs for retraining and optimization of the build of editing tools to minimize manual intervention and maximize compliance. Works through Revenue Cycle leadership to communicate training and optimization needs to clinical leadership, chargemaster committee, compliance, and related areas. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High School Diploma or equivalent. EXPERIENCE: 1. Two (2) years of billing- revenue cycle experience. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Bachelor’s degree in business or other healthcare related field or Health Information Technology graduate. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned