Revenue Integrity Specialist; Revenue Integrity & CDM
Revenue Integrity Specialist; Revenue Integrity & CDM
Job Description
Biweekly Hours: 80.00
Shift: 8:00am -5:00pm
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it. Founded in 1837, Cuyahoga County's safety-net health system operates four hospitals, four emergency departments and more than 20 health centers.
Summary:
Serves as a liaison between hospital, financial, and revenue cycle operations to ensure that charges are accurate and optimizing capture and billing. Evaluates current/future business and/or operational workflows/practices to ensure all charges are documented and captured for the Service Lines. Assists in educating providers, nurses, and non-clinical personnel regarding billing, coding, and reimbursement issues. Recommends/implements updates to existing charge capture processes for new and existing lines of business. Upholds the mission, vision, values, and customer service standards of The MetroHealth System.
Qualifications:
Required: Meets one of the following: • Bachelor's Degree in Business Administration, Healthcare Administration, Finance, or other related field, AND 2 years of billing, coding, and reimbursement experience. • In lieu of degree, will consider 4 years of billing, coding, and reimbursement experience. Possesses one or more of the following certifications/license (applies to all hires effective 4/1/14 or later): • Registered Health Information Administrator (RHIA) from the American Health Information Management Association (AHIMA). • Registered Health Information Technician (RHIT) from AHIMA. • Certified Coding Specialist (CCS) from AHIMA. • Certified Coding Specialist - Physician-based (CCS-P) from AHIMA. • Certified Professional Coder (CPC) from the American Academy of Professional Coders (AAPC). • Certified Outpatient Coder (COC) from the AAPC. • License to practice as a Registered Nurse in the State of Ohio. Strong knowledge of medical coding (must include both ICD-9 and CPT-4 coding). Demonstrated knowledge of the revenue cycle. Computer literate, including experience with the Microsoft Office Suite of software programs. Strong analytical skills. Strong written, verbal, and interpersonal communication skills.
Preferred: Ability to review and interpret managed care contracts and other billing regulations. Demonstrated knowledge of coding and billing regulations for unique clinical areas (i.e. rehab, mental health, skilled nursing, dental, emergency transport, etc.).
Physical Requirements: May sit, stand, stoop, bend, and ambulate intermittently during the day. May need to sit or stand for extended periods. See in the normal visual range with or without correction. Hear in the normal audio range with or without correction. Finger dexterity to operate office equipment required. May need to lift up to twenty-five (25) pounds on occasion. Ability to communicate in face-to-face, phone, email, and other communications. Ability to see computer monitor and departmental documents.
Biweekly Hours: 80.00
Shift: 8:00am -5:00pm
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it. Founded in 1837, Cuyahoga County's safety-net health system operates four hospitals, four emergency departments and more than 20 health centers.
Summary:
Serves as a liaison between hospital, financial, and revenue cycle operations to ensure that charges are accurate and optimizing capture and billing. Evaluates current/future business and/or operational workflows/practices to ensure all charges are documented and captured for the Service Lines. Assists in educating providers, nurses, and non-clinical personnel regarding billing, coding, and reimbursement issues. Recommends/implements updates to existing charge capture processes for new and existing lines of business. Upholds the mission, vision, values, and customer service standards of The MetroHealth System.
Qualifications:
Required: Meets one of the following: • Bachelor's Degree in Business Administration, Healthcare Administration, Finance, or other related field, AND 2 years of billing, coding, and reimbursement experience. • In lieu of degree, will consider 4 years of billing, coding, and reimbursement experience. Possesses one or more of the following certifications/license (applies to all hires effective 4/1/14 or later): • Registered Health Information Administrator (RHIA) from the American Health Information Management Association (AHIMA). • Registered Health Information Technician (RHIT) from AHIMA. • Certified Coding Specialist (CCS) from AHIMA. • Certified Coding Specialist - Physician-based (CCS-P) from AHIMA. • Certified Professional Coder (CPC) from the American Academy of Professional Coders (AAPC). • Certified Outpatient Coder (COC) from the AAPC. • License to practice as a Registered Nurse in the State of Ohio. Strong knowledge of medical coding (must include both ICD-9 and CPT-4 coding). Demonstrated knowledge of the revenue cycle. Computer literate, including experience with the Microsoft Office Suite of software programs. Strong analytical skills. Strong written, verbal, and interpersonal communication skills.
Preferred: Ability to review and interpret managed care contracts and other billing regulations. Demonstrated knowledge of coding and billing regulations for unique clinical areas (i.e. rehab, mental health, skilled nursing, dental, emergency transport, etc.).
Physical Requirements: May sit, stand, stoop, bend, and ambulate intermittently during the day. May need to sit or stand for extended periods. See in the normal visual range with or without correction. Hear in the normal audio range with or without correction. Finger dexterity to operate office equipment required. May need to lift up to twenty-five (25) pounds on occasion. Ability to communicate in face-to-face, phone, email, and other communications. Ability to see computer monitor and departmental documents.
About The MetroHealth System
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it. Founded in 1837, Cuyahoga County’s safety-net health system operates four hospitals, four emergency departments, more than 20 health centers and 40 additional sites.
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