Revenue Integrity Tech

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National Coalition of Healthcare Recruiters
Job Overview

(Only QUALIFIED Healthcare Professionals accepted)
Revenue Integrity Tech

Works with departments to routinely identify compliant charging opportunities, proactively identifying revenue opportunity and suggest improvements with revenue cycle leadership to prioritize audits as it relates to charge capture and/or revenue flow. Responsible for charge audits, ensures that we remain within the standards for resolving edits/issues that appear in eRequest and on Bill45/49. Review payments for accuracy from contracted payers and management of appeal process with assigned audits. Conduct appeals to Medicare to reverse medical necessity denials. Audits and enters charges at or above minimum accuracy and productivity rate set by department leadership (accuracy measured by monthly quality reviews). Inputs charges correctly into charge capture audit system, working with departments, HIM and PFS to assure complete and accurate billing. Monitors reports of accounts via charge capture audit system on a routine basis, keeping number of accounts below goals set by department leadership. Works effectively with revenue cycle department to thoroughly understand how clinical changes impact changes net revenue. Utilizes established coding and charging guidelines for accurate data capture and reimbursement. Knowledge based regarding edits and criteria for corrective action on billing errors, confirms edits are completed timely to insure proper charge capture Review and distribute Medicare Bulletin monthly and meet with department impacted, determines Medicare denial rate and physician education. Fulfills other assigned responsibilities, duties and tasks of them not specifically listed within this job description and as directed by employees Director or Administrative representative.


Qualifications

Bachelors degree in business, healthcare, nursing or related field preferred, Associate level accepted. Three years healthcare experience in audit or coding is required, clinical experience preferred. Coding certification (e.g. CCS, RHIA, RHIT, CPC) or applicable experience is preferred.

Job Detail
  • Job IDnchcr-1925308
  • StreetN/A
  • StateNorth Carolina
  • Postal CodeN/A
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