"Alerted.org

YOU ARE REQUIRED TO SUBMIT A RESUME WITH YOUR APPLICATION!

Revenue Integrity Specialist - AdventHealth -** **Maitland

Location Address:** **900 WINDERLEY PL, Maitland, 32751

Top Reasons to work at AdventHealth -** **Maitland

**Work Hours/Shift:** Full Time 8:00am - 5:00pm

You Will Be Responsible For:

Demonstrates, through behavior, AdventHealths core values of Integrity, Compassion, Balance, Excellence, Stewardship, and Teamwork.

+ Serves as a consultant / liaison to bridge the gap between clinical areas, finance, and revenue cycle departments. Works pro-actively with administration, finance, revenue cycle, nursing, and ancillary management to assure appropriate clinical business performance.

+ Collaborates with the charge auditors regarding service line trends and is responsible for following up with charge auditors when issues or questions arise.

+ Development of policies and procedures to support and sustain improvements.

+ Monitors success of performance improvements and escalates issues and risks to the appropriate stakeholders (e.g. Clinical Liaison Manager and Revenue Integrity Director).

+ Supports clinical information systems ensuring design, maintenance, and utilization complies with charge capture goal.

Qualifications

What You Will Need:

Required:

+ Two (2) years experience in healthcare or related field

+ Ability to work and meet deadlines in a fast-paced, dynamic, project-oriented environment (ever changing).

+ Ability to relate operational performance in the healthcare environment and to present information to all levels of management.

OR

+ Five (5) years clinical experience

+ Licensed Healthcare professional required (e.g. LPN, Radiologic Technologist, Respiratory Therapist, etc.),

OR

+ Professional coding certification (e.g. CPC)

Preferred:

+ Bachelors degree

+ Extensive understanding of correct coding principles of CPT/HCSPCS and modifier selection as well as CCI edits and Universal Billing Guidelines

+ Extensive knowledge of Registration, Medical Records Coding, Government, and Managed Care billing rules, coverage, payment, and compliance

+ Bachelors degree

+ Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).

Job Summary:

The Revenue Integrity (RI) Specialist is responsible for accurate and compliant charge capture through the evaluation and appropriate maintenance of all ambulatory and acute clinical operational processes. This role ensures all aspects of the charge master for assigned departments that successfully achieves accurate and compliant with clinical guidelines, regulatory and billing requirements. The RI Specialist supports the Nurse Reviewer Consultant and Senior RI Specialist to partner and collaborates with clinical departments to perform revenue reviews and charge audits based on the charge capture needs for the success of the hospital. Performs exception-based audits, supports regular meetings and other interactions with all clinical areas. The RI Specialist works directly with the Revenue Cycle Revenue Integrity Charge Auditor teams to develop a proper work plan to ensure improvements are identified and understood by the clinical departments. This role monitors that desired outcomes are sustainable and helps to create an improved revenue capture with reducing tactical denials. The RI Specialist is recognized and heavily relied upon as a subject matter expert in multiple revenue or compliance technical areas by utilizing their knowledge of coding guidelines and charging practices. Adheres to AdventHealth Corporate Compliance Plan and to rules and regulations of all applicable local, state and federal agencies and accrediting bodies. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

**Category:** Patient Financial Services

**Organization:** AdventHealth Orlando

**Schedule:** Full-time

**Shift:** 1 - Day

**Req ID:** 25042063

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.