Revenue Integrity Specialist

Position Title: Revenue Integrity Specialist

Location: 1900 N SUNRISE DR, USA, Saint Peter, MN, 56082

Base Pay: 20.58 - 28.03 / Hour

Description: Description

Responsibilities

a) Complete Excellian work queues daily, as assigned.

b) Research all information needed to submit authorization requests for inpatient and outpatient surgical services.

c)Work with payers on notification for inpatients, observation patients, and discharges.

d) Process and post receipts and insurance payments.

e) Prorate patient accounts following insurance payments.

f) Distribute insurance denials or requests to OS Inc.

g) Scan insurance remits and adjustment requests not located in clearinghouse.

h) With OS Inc, review Accounts Receivable Credit Balance report and refund over payments to appropriate party, as appropriate.

i) With OS Inc, edit HCFA 1500 and UB92 claims for transmission to insurance.

j) Utilize Internet & portals for payer information and stay current with updates. Notify HIM, Central Scheduling, and OS Inc, as appropriate.

k) Attend seminars.

l) Complete incoming correspondence daily.

m) Answer incoming calls and assist Patient Account Rep with billing issues.

n) Maintain strictest confidentiality.

o)Perform other duties as assigned by Patient Financial Services Manager.

p) Adhere to hospital policy.

q)Provide excellent customer service to patients and staff.

r)Provide good communication and work effectively with co-workers and other departments.

s)Ensure that River's Edge Hospital billing practices are in compliance with government laws and CMS regulations.

2. Other Duties
a) Maintain working knowledge of facility fire and disaster plans, accurately and efficiently perform duties in the event of drills and related actual situations.

b)Maintain confidentiality of patient, physician and employee information.

c) Participate in facility committees and work teams as appropriate.

d) Assist in the orientation and training of new employees and/or students.

e) Complete special projects and perform other related duties, as assigned.

Requirements:

High School diploma or GED with degree in Medical Billing, preferred

Three years combined of medical billing and accounts receivable experience, preferred

Knowledge of hospital billing practices, policies, and procedures

Knowledge of insurance related to reimbursement procedures and practices

Ability to prepare records in accordance with detailed instructions and examine documents for accuracy

Experience obtaining Prior Authorizations and Inpatient Notifications

Ability to prepare claims for accurate reimbursement and to meet deadlines

Preferred experience with Excellian/Epic Resolute patient accounting system

Excellent skills in oral and written communication

Ability to work effectively with patients and co-workers

Possess strong customer service skills

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