Revenue Integrity Clinical Systems Specialist

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

Benefits offered by this job

Medical, Dental and Vision plans

401(k) plan with a match

PTO and Sick time

Tuition Reimbursement

Job summary

Silver Cross Hospital in New Lenox, IL is seeking a Revenue Integrity Clinical Systems Specialist to monitor charging policies across departments and ensure compliant charge capture to optimize reimbursement.

The role conducts insurance audits, communicates clinical billing information to staff, updates the charge master, and collaborates with revenue cycle leadership to resolve denials and obtain necessary authorizations.

Qualifications

• Associate of Science Degree in a medically related field.
• Minimum of two years of experience in a Patient Accounting environment.
• Microsoft Excel is an intermediate skill.

Responsibilities

• Monitor and analyze charging policies and practices to ensure compliant charging and optimize reimbursement.
• Conduct and coordinate insurance audits through site visits by insurance auditors.
• Educate clinical and non-clinical staff on billing policies and updates to the charge master.
• Collaborate with Revenue Cycle Leadership and Accounting to manage MCO-authorized services and resolve denials.
• Appeal denials and assist in obtaining authorizations for in-house patients.

Skills

Excel

Education

Associate of Science in a medically related field

Bachelor's in Accounting or BSN (strongly preferred)

Job description

Revenue Integrity Clinical Systems Specialist page is loaded## Revenue Integrity Clinical Systems Specialistlocations: New Lenox, Illinoistime type: Full timeposted on: Posted Yesterdayjob requisition id: R-0012453## Silver Cross Hospital is an extraordinary place to work. We're known for our culture of excellence and delivery of unrivaled experiences for 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:a. If RN, current State of Illinois licensureb. 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 - $32.30The 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.