Revenue Integrity Clinical Systems Specialist

Silver Cross Hospital; New Lenox (IL); On-site; USD 36,000 - 44,000; Full time

Benefits offered by this job

Medical Plan

Dental Plan

Vision Plan

Life Insurance

401(k) match

Wellness program

Tuition Reimbursement

PTO & Sick Time

Job summary

Silver Cross Hospital in New Lenox, IL is seeking a billing specialist to monitor charging policies, optimize reimbursement, and educate staff on billing practices. You will coordinate audits, interpret clinical info for billing, and collaborate with departments to improve charge capture.

Requirements include an AS degree in a medically related field; two years in patient accounting; intermediate Excel skills; a BS in Accounting or BSN is strongly preferred; licensure per RN or RHIT/CCS may

Qualifications

• AS degree in a medically related field is required.
• Two years of experience in a Patient Accounting environment preferred.
• Bachelor’s Degree in Accounting or BSN strongly preferred.

Responsibilities

• Monitor and analyze charging policies for all hospital departments.
• Communicate and apply knowledge to clinical and non-clinical management to optimize reimbursement.
• Conduct and complete insurance audits and coordinate issue resolution with work groups.

Education

Associate of Science Degree in a medically related field

Bachelor’s Degree in Accounting

Bachelor of Science in Nursing (BSN)

Tools

Microsoft Excel

Job description

Silver Cross Hospital is an extraordinary place to work. We’re known for our culture of excellence and deliveryof unrivaled experiencesfor our patients, their families, the communities we serve…and for each other. Come join us! It’s the way_you_want to be treated.

Summary: Directly responsible for monitoring and analyzing charging policies and practices for all hospital departments and applying and communicating that knowledge to both clinical and non-clinical management in order to facilitate correct and compliant charging and optimize reimbursement. Responsible for conducting and completing insurance audits through site visits by insurance auditors. Acts as a liaison and interpreter of clinical information as it relates to billing to patients, and all departments within Silver Cross Hospital. Analyzes and identifies breakdowns in processes that have financial impacts and coordinates appropriate work groups to resolve the issues. Educates clinical and non-clinical staff on billing policies. Keeps up to date on reimbursement and denial trends. Works cooperatively with clinical leaders to develop and improve charge capture and documentation. Updates and maintains Charge master in collaboration with the clinical departments, Patient Accounts Management, Revenue Cycle Leadership, and Accounting. Manage Managed Care Organization (MCO) authorized services to both the inpatient and outpatient population. Ensure correct coding providing feedback to billing and collection staff when questions arise. Appeal clinical denials, regardless of the denial source; appeals will be both verbal and written. Assist in obtaining authorizations for current inhouse patients.

Requirements: An Associate of Science Degree in a medically related field. Minimum of two years of previous experience in a Patient Accounting environment. Microsoft Excel – intermediate level of skill. Bachelor’s Degree in Accounting or Bachelors of Science in Nursing strongly preferred. Required License and/or Certification:

1. If RN, current State of Illinois licensure
2. If coder, Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS)

Work Shift Details

Days, Days, Monday through Friday

Department

PATIENT ACCOUNTS

Benefits for You

At Silver Cross Hospital, we care about your health and well-being and that is why we work hard to provide quality and affordable benefit options for you and your eligible family members.

Silver Cross Hospital and Silver Cross Medical Groups offer a comprehensive benefit package available for Full-time and Part-time employees which includes:

• Medical, Dental and Vision plans
• Life Insurance
• Flexible Spending Account
• Other voluntary benefit plans
• PTO and Sick time
• 401(k) plan with a match
• Wellness program
• Tuition Reimbursement

Registry employees who meet eligibility may participate in our 401(k) Savings plan with a potential match. However, registry employees are ineligible for Health and Welfare benefits.

The expected pay for this position is listed below:

$25.84 - $32.30

The final pay rate offered may be more than the posted range based on several factors including but not limited to: licensure, certifications, work experience, education, knowledge, demonstrated abilities, internal equity, market data, and more.