Revenue Integrity Specialist

Reporting to the Manager, Revenue Integrity, the Revenue Integrity Specialist is responsible for coordinating all aspects of charge capture with improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation.

Under supervision from the Manager, Revenue Integrity, the Revenue Integrity Specialist is responsible for the facilitation of multiple Revenue Integrity initiatives to support individuals and teams working on Revenue Integrity initiatives focusing on revenue cycle integrity. Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, well-developed analytic and organizational skills. The Revenue Integrity Specialist applies a variety of continuous improvement and process improvement initiatives working with individuals and teams from project conception to implementation of process improvement initiatives. Project work may include technical analyses or may require facilitation of a large multi-disciplinary group of operations and/or medical personnel. Works collaboratively with leadership to increase efficiencies, reduce variability, reduce errors/defects, and involve all appropriate personnel. Prepares reports and recommendations for management and coordinates implementation whenever possible. This individual provides needed continuous improvement training and education and works closely with other Revenue Integrity personnel to meet education needs at all levels throughout the hospital. Communicates regularly with Management on specific projects. Flexibility, innovation, and creativity are necessary characteristics of the successful candidate. Individual is expected to continuously learn and apply new continuous improvement methodologies, and to spread successful innovation through the institution.

• Works directly for the Revenue Integrity Manager as part of the Revenue Cycle team.
• Responsibilities will include coordinating and communicating the development of compliant and standard charge capture processes, procedures, and documentation.
• Collaborates with subject matter experts and assigned Epic/I.T. resources as needed to provide appropriate systematic process.
• Monitors and presents the effectiveness of implemented charge capture processes and education by developing charge reports in Epic or related systems.
• Monitors and facilitates revenue cycle activities including pricing, charge capture, revenue recognition and denial management.
• Provide recommendations for financial improvement.
• Provides support for strategic and tactical planning.
• Monitoring of financial performance, achievement of goals and benchmarks, identifying variances, preparing and presenting analyses and reports to VP and management team.
• Facilitate and meaningfully participate in contingency planning and financial forecasting.
• Collaborates with members of revenue cycle, department leadership, clinical staff, and IT to implement, educate, and maintain charge capture improvements across the organization.
• Other duties as required.

Technical Expertise

• Minimum one (1) year experience in healthcare revenue cycle, analysis, and charge-related experience is required. 3- 5 years of experience preferred.
• Knowledge and experience of healthcare revenue cycle required.
• Epic experience is preferred.
• Proven ability in revenue analysis and charge capture methodologies required.
• Strong written and oral communication skills and problem-solving skills required.
• Experience working with all levels within an organization is required.
• Proficiency in MS Office [Outlook, Excel, Word] or similar software is required. Data warehouses, and/or decision support systems and reporting tools experience preferred.

Education and Experience

• Education: Bachelor's degree in Finance, IT, Healthcare Administration, Nursing, or related field is preferred;
• Certification: Coding certification (AAPC or AHIMA) required. Lean/Six Sigma certification is preferred. Revenue certification is preferred.
• Years of relevant experience: 3 to 5 years is preferred.
• Years of experience supervising: None.