Revenue Integrity Specialist

Catholic Health Services; Melville (NY); On-site; USD 80,000 - 86,000; Full time

Job summary

Catholic Health is a premier health system delivering compassionate care across Long Island. This remote role (NY resident) focuses on charge capture, revenue integrity and collaboration with hospital and ambulatory departments to optimize billing processes.

The Revenue Liaison works with revenue leads to ensure accurate charge capture, reconciliations and error correction, while guiding departments on compliant coding practices and process improvements.

Qualifications

• Bachelor's degree in healthcare or business related field.
• Three+ years in charge documentation, charge audit or charge capture.
• CPC or CCS-P certification required.

Responsibilities

• Guide correct charge capture and billing with clinical departments.
• Review charge capture for PRC departments.
• Identify trends and resolve revenue-related issues.
• Identify opportunities to capture additional revenue per payer rules.
• Modify charge capture applications to reduce charge-related edits/rejections.
• Coordinate research and implementation of charge capture processes for new services and/or new technology.
• Collaborate with Coding and clinical departments to resolve ICD/CPT errors.
• Lead meetings to discuss charge capture findings.
• Assist in developing revenue integrity training documentation and policies.

Skills

Charge capture

Billing processes

ICD/CPT coding

Data analysis

Communication

Time management

Education

Bachelor's degree

Tools

Microsoft Office

Epic HB/PB

Job description

Overview

Catholic Health is one of Long Island’s finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island.

At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes – to every patient, every time.

We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace!

Job Details

*This is a remote role, but must reside in New York State

The responsibility of this position is to serve as the revenue liaison between the revenue cycle management departments, the hospital and ambulatory departments, and any physician/provider area that generates revenue for the professional component. This position is responsible for collaborating with department revenue leads and staff to ensure accurate charge capture operations are in place to include daily charge capture, revenue reconciliation and error correction processes.

DUTIES/RESPONSIBILITIES

• Provides guidance and communication on correct charge capture and billing processes to clinical department and facilities.


• Perform periodic reviews and assessments of charge capture for PRC Departments.


• Identifies trends and participates in the resolution of revenue/charge related issues.


• Identifies opportunities for capturing additional revenue in accordance with payer guidelines.


• Develops specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.


• Coordinates and assists with research and implementation of charge capture processes for new services and/or new/updated technology.


• Works with Coding and clinical departments to identify/resolve errors based on ICD/CPT Coding Guidelines and National Correct Coding Initiative edits.


• Responds to departmental charging inquiries timely.


• Leads meetings to discuss charge capture findings.


• Assists in developing revenue integrity training documentation and policies for training and education within the Revenue Integrity team and departments providing physician services.


• Performs other duties as assigned.

POSITION REQUIREMENTS AND QUALIFICATIONS

Education

• Bachelor's degree in Healthcare or Business Administration, Finance, Accounting, Nursing, or a related field, or an equivalent combination of years of education and experience.

Skills

• Proficient presenting to and interacting with all levels of ambulatory and hospital management.


• Possess strong interpersonal skills in order to integrate and successfully function with all levels of the organization.


• Extreme attention to detail, highly developed organizational skills, and ability to prioritize assignments.


• Excellent communication skills: both verbally and in written text.


• Superior analytical and problem solving skills.


• Self-directed with ability to work independently and manage time effectively.


• Ability to identify and redesign inefficient workflows and processes; offer guidance and quality decisions.


• Positive and professional attitude, with a strong emphasis on working as a team.


• Perform quality work within deadlines.

Experience

• Three (3) or more years of experience in charge documentation, charge audit or charge capture activities.


• Proficient knowledge of ICD/CPT coding required; CPC or CCS-P required.


• Strong computer literacy required including proficiency in relevant software including, Microsoft Office (Excel, PowerPoint, and Word; Access a plus).


• Epic HB/PB experience preferred.


• Related Epic certification and/or Epic proficiency preferred.

Salary Range

USD $80,000.00 - USD $86,000.00 /Yr.

This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate’s qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits.

At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.