Revenue Integrity & Denials Analyst

University of Toledo; Toledo (OH); Hybrid; USD 60.000 - 85.000; Vollzeit

Zusammenfassung

University of Toledo Physicians seeks a Revenue Integrity Specialist II to advance denial management and ensure accurate claim submission. This hybrid role communicates issues and trends to stakeholders and works independently to plan efforts impacting reimbursement and reducing denials.

The position emphasizes reviewing denials, coding compliance, and collaboration with the coding and billing team to improve the revenue cycle. 403B, pension, and tuition benefits apply.

Qualifikationen

• Education: High-school diploma or equivalent.
• Certification: Current coding certification (CPC, CPC-H, CCS-P, RHIT, CCA, etc.) or willingness to obtain within 12 months.

Aufgaben

• Identify denial patterns and escalate to management as appropriate.
• Make recommendations for changes to work queues and claim edits to reduce denials.
• Review payer communications and policies to identify potential coding issues.
• Identify opportunities for coding and documentation process improvement.
• Identify root causes of denials.
• Review denied claims for correct coding and resubmit as needed.
• Provide regular feedback to team members and educators.
• Collaborate with billing/coding management to rectify concerns.
• Ensure effectiveness of pre-bill edits and clean claims.
• Maintain knowledge of regulations and payer policies.

Kenntnisse

Independent work

Communication

Organizational skills

Analytical thinking

Microsoft Office

Prioritization

Team collaboration

Judgment & problem solving

Confidential handling

Ausbildung

High-school diploma or equivalent

Coding certification (CPC, CPC-H, CCS-P, RHIT, CCA, etc.)

Tools

EPIC

Jobbeschreibung

University of Toledo Physicians seeks a Revenue Integrity Specialist II to advance denial management and ensure accurate claim submission. This hybrid role communicates issues and trends to stakeholders and works independently to plan efforts impacting reimbursement and reducing denials.

The position emphasizes reviewing denials, coding compliance, and collaboration with the coding and billing team to improve the revenue cycle. 403B, pension, and tuition benefits apply.