Revenue Integrity Specialist (FT) Remote

Ballad Health; Johnson City (TN); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare company seeks a Revenue Integrity Specialist to analyze patient accounts and improve charge capture accuracy. Candidates should have clinical coding experience or LPN background, strong problem-solving skills, and be proficient with Microsoft Office. This role involves collaboration across departments and maintaining compliance with billing guidelines.

Qualifications

• Minimum of 2 years of clinical or coding experience required.
• Knowledge of charge processes, coding, billing, and reimbursement methodologies is essential.
• Must have valid and active LPN licensure or relevant coding certification.

Responsibilities

• Analyze patient accounts for charge capture opportunities.
• Collaborate with clinical departments to enhance charge accuracy.
• Educate revenue departments on effective charging practices.

Skills

Customer Service

Problem Solving

Decision-Making

Education

LPN program graduate

CCA, CPC, or CCS certification

Tools

Microsoft Office Suite

Job description

SCOPE OF POSITION
The Revenue Integrity Specialist will analyze patient accounts to identify charge capture opportunities and work with Ballad Health clinical departments to improve charge capture accuracy by closing feedback loops to those departments. The Specialist must be able to thoroughly and accurately analyze medical records, understand charge capture workflows, and follow appropriate billing guidelines.

This individual will collaborate closely with Compliance staff, the Charge Master Team, Coding, and other departments within the organization to enhance overall charge control for Ballad Health facilities. The Specialist will provide education to revenue departments when trending indicates less effective charging practices. They must understand different payer billing requirements to mitigate denial risks.

This position involves routine and project-based work. The Specialist must be a proficient communicator, capable of speaking in front of groups and relating well to all staff levels. They should be able to recommend and implement quality control systems to ensure functions are efficient, effective, and compliant with policies and standards. Since the role involves access to patient information, maintaining confidentiality is essential.

Ballad Health encourages all team members to support the Operational Excellence initiative by demonstrating awareness of the lean system and applying it effectively in their work.

This role may require access to protected health information (PHI). The team member will be responsible for appropriate use of records and compliance with confidentiality and security policies related to PHI.

REPORTING RELATIONSHIP
See Table of Organization.

EDUCATION AND EXPERIENCE
Graduates of an accredited LPN program are preferred. Ideally, candidates will have hospital experience as an LPN or experience in coding within a hospital setting. A minimum of two years of clinical or coding experience is required. The candidate must be able to work independently, be self-motivated, and conduct independent research. Knowledge of charge processes, coding, billing, and reimbursement methodologies is essential. Experience with business applications, including Microsoft Office Suite, is required. Strong customer service, problem-solving, and decision-making skills are also necessary.

Valid and active LPN licensure in the appropriate state, or valid and active CCA, CPC, or CCS certification.