Revenue Integrity Specialist II (work from home Eastern United States)

Lensa; Danville (PA); Remote; USD 45,000 - 60,000; Full time

Job summary

A leading career site is seeking a Revenue Integrity Specialist II to work from home in the Eastern United States. This role involves capturing and analyzing hospital charges, ensuring accurate billing, and collaborating with clinical operations. The ideal candidate will have a high school diploma and at least 2 years of related experience.

Qualifications

• Minimum 2 years related work experience required.
• High School Diploma or GED required.

Responsibilities

• Capture, analyze, monitor, and reconcile hospital and professional charges.
• Ensure correct billing submissions with minimal supervision.
• Participate in developing revenue management and strategic plans.

Skills

Knowledge of hospital and professional charge capture

Analytical skills

Communication

Education

High School Diploma or GED

Job description

Revenue Integrity Specialist II (work from home Eastern United States)

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Geisinger Health System, is seeking professionals. Apply via Lensa today!

Job Summary

Provides functions to capture, analyze, monitor, and reconcile hospital and professional charges. Executes programs to ensure efficient operations that generate sufficient cash flow to support organizational needs. Responsibilities include capturing revenue, resolving edits, making adjustments, analyzing and monitoring hospital and professional services. Collaborates with Clinical Operations staff to ensure timely revenue capture, identifies trends and omissions.

Job Duties

1. Knowledge of hospital and professional charge capture and billing processes.
2. Completes hospital and professional edits as assigned.
3. Analyzes documentation in the Electronic Medical Record (EMR) for edit resolution.
4. Manually captures hospital and professional charges, validates information, logs and batches charge documents, and ensures accurate data entry.
5. Performs self-pay adjustments as directed.
6. Completes charge corrections as needed.
7. Gathers missing data by conferring with coders, providers, clinical operations, and RMPC.
8. Ensures correct billing submissions with minimal supervision, maintaining cost-effectiveness and organizational efficiency.
9. Communicates activities and issues to management related to revenue capture, edits, reconciliation, and organizational profitability.
10. Coordinates with other departments to meet revenue management needs.
11. Participates in developing revenue management and strategic plans.
12. Assists in recruiting, training, and onboarding new specialists.
13. Provides coverage and support to team members for timely and accurate charge processing.
14. Maintains departmental operations within performance and quality targets.
15. Analyzes trends and issues, recommending solutions.
16. Supports other departments as needed, including training.

Work Environment and Requirements

Work typically performed in an office setting. Must comply with all organizational policies and procedures.

Position Details

Internet Requirements

• Cable modem, high-speed only (no DSL, wireless, or satellite)
• 25 Mbps upload, 75 Mbps download
• Ethernet connection required; Wi-Fi permitted only with VPN

Education

High School Diploma or GED (Required)

Experience

Minimum 2 years related work experience (Required)

Values and Culture

Our purpose is caring for patients, members, students, and communities. We value kindness, excellence, learning, innovation, and safety. We offer comprehensive benefits, foster collaboration, and embrace diversity. We are an equal opportunity employer, encouraging women and minorities to apply.

Additional Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Accounting/Auditing and Finance
• Industries: IT Services and IT Consulting

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