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Revenue Integrity Analyst

Job Details

Location:
Cape Coral, FL 33990

Category:
Professional

Type:
Full Time

Schedule:
Days

Job Ref:
66558

Location:Santa Barbara Professional Center -224 Santa Barbara BlvdCape Coral FL 33991

Department: Patient Business Office

Work Type: Full Time

Shift: Shift 1/7:00:00 AM to 3:30:00 PM

Minimum to Midpoint Pay Rate:$22.78 - $29.62 / hour

Summary

The Revenue Integrity Analyst will be responsible for supporting management in maintaining, improving, processing, and evaluating the billing and collection of facility government receivables. Position will include resolving AHCA reporting errors, Lab charge reviews, Medicare monthly reporting, conducting Medicare inpatient pre-billing reviews and government payer post billing reviews for accuracy. Is the point person between departments and external entities for audits to ensure clear communication, collaboration and timely resolution of audits. Maintains the PECOS claims data. Will facilitate improvements in system policies and procedures to ensure compliance requirements, including Federal and state guidelines and requirements of participation, are met.

Critical to this position is a highly developed knowledge of the hospital revenue cycle including registration, charge capture, coding, billing, collection, utilization management and account balance resolution.

The Revenue Integrity Analyst must demonstrate an advanced level of proficiency in billing and compliance across all government payers and will make claim-related decisions to facilitate resolution of complex claim issues. The Revenue Integrity Analyst must also demonstrate strong organizational, communication, time management and analytical skills. Must have a working knowledge of government audit guidelines to provide guidance on day to day processes to ensure compliance is maintained when changes are required by payers. The ability to manage multiple priorities and problem solve effectively is essential.

AAHAM Certified Compliance Technician required, must be obtained within one year of accepting position. High School Diploma or Equivalent required. Ability to type 20 wpm and working knowledge with Microsoft Office products including Excel, Outlook and One note. Experience with DDE, Epic, SSI Billing System, and Document Imaging are a plus.

Requirements

Educational Requirements

Degree/Diploma ObtainedProgram of StudyRequired/
Preferred
and/or
High School Diploma or EquivalentRequired

Additional Requirements

Prefer Bachelor Degree or higher formal education, 2 years formal education post high school in clinical, financial, or coding program.

Experience Requirements

Minimum Years RequiredArea of ExperienceRequired/
Preferred
and/or
3 YearsHealthcareRequired

Additional Requirements

3 experience in healthcare-related field, in hospital billing, coding and/or charging/reimbursement-related capacity. Additional clinical experience in related field a plus.

State of Florida Licensure Requirements

LicensesRequired/
Preferred
and/or
Not Required

Certifications/Registration Requirements

Certificates/RegistrationsRequired/
Preferred
and/or

Additional Requirements

Coding certification preferred to include CPT, HCPCS, ICD9-10, and DRG

US:FL:Cape Coral

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