Healthcare Revenue Integrity Specialist

ScionHealth; Columbus (GA); On-site; USD 42,000 - 56,000; Full time

Job summary

St. Francis–Emory Healthcare, a 376-bed community-connected hospital in Columbus, GA, seeks a Revenue Cycle Specialist to assist in resolving billing edits that hold patient claims from Billing by reviewing medical records and documentation.

You will improve the accuracy and integrity of patient charges and coordinate audits. The role requires critical thinking, the ability to work under pressure, and experience with precertification/authorizations and claim editing.

Qualifications

• High school diploma or equivalent required; revenue integrity preferred.
• Experience with medical coding and payer types preferred.
• Strong communication and documentation skills.

Responsibilities

• Resolve billing edits that hold patient claims from Billing.
• 0
• Review medical records and documentation to ensure accurate charges.
• Coordinate retrospective, concurrent, and external billing audits.
• Interact with ancillary departments to obtain information needed to bill correctly.
• Assist with charge audits and reconciliations as needed.

Skills

Critical thinking

Ability to work under pressure

Precertification & authorizations

Claim/editing accuracy

Communication with patients/customers

Charge master liaison

SOX charge audits

Preceptor/educational support

Education

High School Diploma or Equivalent

Certified Revenue Integrity Professional (Preferred)

Tools

Parallon eRequest

Job description

St. Francis–Emory Healthcare, a 376-bed community-connected hospital in Columbus, GA, seeks a Revenue Cycle Specialist to assist in resolving billing edits that hold patient claims from Billing by reviewing medical records and documentation.

You will improve the accuracy and integrity of patient charges and coordinate audits. The role requires critical thinking, the ability to work under pressure, and experience with precertification/authorizations and claim editing.