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Currance · 3 days ago

Revenue Integrity Specialist

Los Angeles, CA

Full-time

Onsite

Mid Level

3+ years exp

Currance is a company that values the unique skills and experiences of its team members. The Revenue Integrity Specialist will support Revenue Cycle Operations by managing front end billing issues, ensuring timely reimbursement, and maintaining charge integrity across all services. This role involves collaboration with various departments to enhance reimbursement processes and decrease denials.

Health CareHospital

Hiring Manager

Carlee Farrington

Responsibilities

Must be onsite M-F, full time in downtown LA

Utilizes health system and external system tools to monitor charges and edits to ensure timely and accurate reimbursement of services rendered

Conducts ongoing Charge Master activities (reviews, consolidation, revenue routing, etc.) to ensure compliance with Federal guidelines

Enters charges and/or corrections into the appropriate system. Resolve all pre-billing edits and reconcile charge reports within the defined statement of work

Prepares and analyzes reports on a regular basis for governmental and regulatory data, including Medicare Bad Debt and Medicare Credit Balance, and works with the leadership to help resolve any related issues

Establishes and maintains access within the payer proprietary portals, clearinghouses, and any client specific websites required by the Revenue Cycle and financial team members

Collaborate closely with other teams to proactively identify and resolve issues or variances in expected volumes

Work directly with the leadership team to achieve strategic and operational objections of the department

Support department leadership in maintaining a high level of charge data integrity

Maintain strict confidentiality and adhere to all HIPAA regulations in handling financial and patient information

Qualification

Hospital billing experienceCharge Master softwareICD-10CPT codesMicrosoft Office SuiteHFMA CRCR certificationMedical accounts investigationDecision makingPositive outlook

Required

3 years of experience working with hospital charge master

Experience with multiple host systems and Charge Master software

Expertise with computer including Microsoft Office Suite/Teams and GoToMeeting/Zoom, etc

Complete the HFMA Certified Revenue Cycle Representative (CRCR) within the first 90 days of employment

Knowledge of ICD-10 Diagnosis and procedure codes and CPT/HCPCS codes

Knowledge of rules and regulations relative to Healthcare Revenue Cycle administration

Skilled in medical accounts investigation

Skilled in achieving results with little to no oversight

Skilled to investigate and resolve escalated claims

Skilled in research to identify new rules and regulations relative to Healthcare Revenue Cycle administration

Ability to validate payments

Ability to make decisions and take action

Ability to maintain a positive outlook, pleasant demeanor, mature nature during all interactions, and act in the best interest of the organization and the client

Ability to take professional responsibility for quality and timeliness of work product