Division Revenue Integrity Specialist

Division Revenue Integrity Specialist Remote Altamonte Springs, FL

 AdventHealth Corporate

• Job Schedule:Full-time

• Pay Range:$21.73 - $40.42 per hour

 

Shift : Monday-Friday

Job Location : Remote, Ability to travel out of state up to 10%

The role you will contribute:

The Division Revenue Integrity Specialist works collaboratively in a team environment to proactively identify opportunities and recommend options for enhancing revenue with the support of Revenue Integrity leadership and clinical departments. This role actively communicates and presents pertinent information to various audiences particularly clinical and Revenue Integrity stakeholders. The position works with the Divisional Revenue Integrity team to develop a work plan to ensure improvements are identified and understood by clinical department management and staff to ensure expected outcomes are successful and result in identifying revenue capture opportunities. The Division Revenue Integrity Specialist will report to the Division Revenue Integrity Manager and will support the work of the Revenue Integrity Analysts. This role will continue to grow and adapt as required to achieve AdventHealth's vision of a world-class revenue cycle.

The value you will bring to the team:

· Act as a subject matter lead over services line(s) related to charging and RI best practice.

· Two to three years of healthcare revenue cycle experience with a focus in one or more of the following areas: coding, charge integrity, charge reconciliation, charge compliance, charge auditing, CDM compliance / or relevant clinical hospital experience.

· isolate revenue leakage improvements through clinical workflow and IT (Information Technology) application optimizations

· proactively identify charging opportunities and issues for low, medium, and high complex service lines and engage with clinical departments (e.g., Clinical Operational Revenue Champions (CORC)), when applicable

· Educate Gide department charge champions on workqueue , capture revenue leakage across service lines and determine the best methods and tools for training and education.

· Work with clinical leadership related to Nursing/Staff Charge Capture deficiencies.

· Lead clinical education focused on charge capture and RI opportunities specific for service lines; work in coordination with AIT (AdventHealth Information Technology) / Clinical Informatics for additional education material (e.g., charge capture opportunities) for clinical end-users.

· Participate in new service lines, charge structure, and build considerations for the clinical (documentation criteria to trigger charge) and IT workflows (CDM and Epic Master File updates)

· Reviews and recommend updates of Epic edits; logic behind clinical department exception-based edits and Revenue Guardian workqueues for each service line.

· Identify data driven Divisional clinical revenue issues and communicate to Divisional Director

· Utilize Epic reporting tools to support operations.

· Support Divisional business growth and other Divisional projects affecting RI (Epic, Acquisitions, etc.)

· Perform other duties as assigned and volunteer for region and division team assignments; actively participate in team projects and implement changes.

The expertise and experiences you’ll need to succeed:

• 2 years of applicable experience

• Excellent written, organizational, communication, and critical thinking skills.

• Advanced knowledge of Microsoft applications including Word, Excel, Visio, Outlook, and PowerPoint

• Customer service oriented, timely in responses to requests for service/information

• Manages multiple and complex tasks, priorities, and people.

• Works independently when necessary and possesses leadership skills.

• Must enjoy working in a fast-paced, collaborative, team-based environment.

• Ability to travel within state and out of state up to 10%

Preferred Qualifications:

• Bachelor's in Business, Accounting, Finance, Health Administration, or another related field Preferred

• Preferred licensure includes coding credentials (e.g., COC, CPC, CCS, RHIT, RHIA, etc.) and / or Active clinical license (e.g., MA, LPN, RN, Pharm Tech, PharmD) Preferred

• 2 years of healthcare revenue cycle experience with a focus in one or more of the following areas: coding, charge integrity, charge reconciliation, charge compliance, charge auditing, CDM compliance, and Hospital / Professional Billing Or relevant clinical hospital experience. Preferred

• Epic experience Preferred

Category: Patient Financial Services

Organization: AdventHealth Corporate

Schedule: Full-time

Shift: 1 - Day