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Senior Revenue Integrity Specialist

Job Details

Location:
Fort Myers, FL

Category:
Patient Billing

Type:
Full Time

Schedule:
Days

Job Ref:
68253

Location: Remote - FL

Department: Department of Revenue Integrity

Work Type: Full Time

Shift: Shift 1/8:00:00 AM to 4:30:00 PM

Minimum to Midpoint Pay Rate:$40.36 - $52.47 / hour

Summary

Requires extensive knowledge of all aspects of healthcares revenue cycle including registration, charge capture, coding, billing and collection processes and a full understanding of the requirements of Medicare, Medicaid and all other major third party payers. Must have an understanding and hands on expertise in utilizing EPIC, Tstar, Diver and other tools used in the revenue cycle. Understands revenue, CPT/HCPCS, ICD-10, DRG and APC codes to ensure the accuracy of the charge master and reimbursement. Develops appropriate strategies for all changes in reimbursement and enlists the assistance of a multi-disciplinary team to assist with the implementation of any process or reimbursement change. Must understand Medicares PPS/OPPS program which includes the cost report, wage index, capital payment and DSH payments, as well as, their impact on reimbursement. Annually contributes data for the completion of the Medicare Cost Report and AHCAs hospital information report. Required to understand and be able to communicate complex issues and changes relating to regulatory compliance and third-party reimbursement to leadership. Apply knowledge of third party payer programs for the monthly determination of net patient revenue for assigned entities and/or cost centers. Must have extensive financial knowledge relating to the completion of reimbursement/revenue cycle responsibilities. Will assist in the analysis of monthly financial statements, as well as, the annual audit and budget. Must assist financial analysts with the utilization of LMHS cost accounting system in the development of reliable financial proformas.

Requirements

Educational Requirements

Degree/Diploma ObtainedProgram of StudyRequired/
Preferred
and/or
Bachelor'sAccountingRequiredor
Bachelor'sFinanceRequiredor
Bachelor'sHealth AdministrationRequiredand
Master'sBusiness AdministrationPreferredor
Master'sHealthcare AdministrationPreferred

Experience Requirements

Minimum Years RequiredArea of ExperienceRequired/
Preferred
and/or

Additional Requirements

Experience in nursing, clinical, HIM/Coding or other allied healthcare related field.

State of Florida Licensure Requirements

LicensesRequired/
Preferred
and/or

Certifications/Registration Requirements

Certificates/RegistrationsRequired/
Preferred
and/or
CCS (Certified Coding Specialist)Required

US:FL:Fort Myers

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