Job Description:
Summary:
The Revenue Integrity Specialist will analyze patient accounts to identify charge capture opportunities, and work with Ballad Health clinical departments to improve charge capture accuracy by closing the feedback loops to those respective departments. The Specialist must be able to thoroughly and accurately analyze the medical record, understanding charge capture workflow and appropriate billing guidelines.
This individual will work closely with the Compliance staff, Charge Master Team, Coding, and all departments within the organization in an effort to enhance the overall charge control for Ballad Health facilities. The Specialist will provide education as required to revenue departments where trending has demonstrated less desirable charging practices. This individual must understand different payer billing requirements to mitigate the risk of denials.
This position consists of routine and project oriented work. The Specialist must be a proficient communicator, be able to speak in front of people and be able to relate well to all levels of staff. The Specialist must be able to recommend and implement quality control systems to ensure the assigned functions and activities are efficient, effective and in compliance with internal and external policies and standards. Additionally, the Specialist will have access to patient information may be necessary to perform these job duties; therefore, ability to maintain confidentiality is a requirement.
Ballad Health expects all team members to support the Operational Excellence initiative by demonstrating awareness of the lean system and effectively applying it to his/her work.
Job duties of this position may require access to protected patient information (PHI). The team member will be accountable for appropriate use of the record and compliance with all confidentiality and security policy and procedures related to use, access, and disclosure of PHI.
Requirements:
Graduate of an accredited LPN program or a certified outpatient coder preferred. Minimum five years clinical, coding or billing experience is required. This position requires someone who can work independently, is self-motivated and possesses the ability to conduct independent research. Working knowledge of charge processes, coding, billing, and reimbursement methodologies is required. Experience with business computer applications, including Microsoft Office Suite, required. Customer service skills. Excellent problem solving skills and decision making abilities.
Licenses and Certifications:
Work Requirements:
Shift: Day
On Call: No
Weekends: Rotating
Travel Required: No
Location:
Ballad Health Medical Associates
