Senior Revenue Integrity Specialist

Davita Inc.; Fort Myers (FL); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization seeks a Revenue Cycle Specialist to ensure accuracy and compliance in healthcare billing and collections. The role includes collaborating with teams for reimbursement strategies, utilizing tools like EPIC, and requiring strong knowledge of Medicare, Medicaid, and coding standards. Candidates with a Bachelor's in Accounting, Finance, or Health Administration are preferred, along with CCS certification.

Qualifications

• Requires extensive knowledge of healthcare revenue cycle.
• CCS certification is required.
• Experience in nursing or related healthcare fields preferred.

Responsibilities

• Develop strategies for reimbursement changes.
• Ensure accuracy in charge master and reimbursement.
• Communicate regulatory issues to leadership.

Skills

Healthcare revenue cycle knowledge

Coding accuracy

Financial analysis

Regulatory compliance

Education

Bachelor's in Accounting

Bachelor's in Finance

Bachelor's in Health Administration

Master's in Business Administration

Master's in Healthcare Administration

Tools

EPIC

Tstar

Diver

Job description

Location: Remote - FL

Department: Department of Revenue Integrity

Work Type: Full Time

Shift: Shift 1/8:00 AM to 4:30 PM

Minimum to Midpoint Pay Rate: $40.36 - $52.47 / hour

Summary

Requires extensive knowledge of all aspects of healthcare revenue cycle including registration, charge capture, coding, billing, and collection processes. Must have a full understanding of Medicare, Medicaid, and other major third-party payers. Hands-on expertise in utilizing EPIC, Tstar, Diver, and other revenue cycle tools is required. Understands revenue, CPT/HCPCS, ICD-10, DRG, and APC codes to ensure accuracy of the charge master and reimbursement. Develops strategies for reimbursement changes and collaborates with multidisciplinary teams for implementation. Must understand Medicare PPS/OPPS programs, including cost reports, wage index, capital payments, and DSH payments, and their impact on reimbursement. Contributes data annually for Medicare Cost Reports and hospital information reports. Communicates complex regulatory and reimbursement issues to leadership. Applies third-party payer knowledge for monthly net patient revenue determination and assists in financial analyses, audits, and budget development. Supports financial analysts with LMHS cost accounting system for financial projections.

Requirements

Educational Requirements

Degree/Diploma Obtained	Program of Study	Required/Preferred
Bachelor's	Accounting	Required
Bachelor's	Finance	Required
Bachelor's	Health Administration	Required
Master's	Business Administration	Preferred
Master's	Healthcare Administration	Preferred

Experience Requirements

Minimum years of experience and area of experience are not specified; relevant experience in healthcare revenue cycle is implied.

Additional Requirements

Experience in nursing, clinical, HIM/Coding, or related healthcare fields.

State of Florida Licensure Requirements

Licenses: Not specified as required or preferred.

Certifications/Registrations

Certificates/Registrations	Required/Preferred
CCS (Certified Coding Specialist)	Required