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The MetroHealth System (Cleveland, OH) · 7 hours ago

Revenue Integrity Specialist; Revenue Integrity & CDM

Cleveland, OH

Full-time

Onsite

Entry, Mid Level

2+ years exp

The MetroHealth System is redefining health care by going beyond medical treatment to improve community health and well-being. The Revenue Integrity Specialist serves as a liaison between various operations to ensure accurate charge capture and billing, while also educating staff on billing and coding issues.

Health CareHospitalMedical

Responsibilities

Serves as a liaison between hospital, financial, and revenue cycle operations to ensure that charges are accurate and optimizing capture and billing

Evaluates current/future business and/or operational workflows/practices to ensure all charges are documented and captured for the Service Lines

Assists in educating providers, nurses, and non-clinical personnel regarding billing, coding, and reimbursement issues

Recommends/implements updates to existing charge capture processes for new and existing lines of business

Upholds the mission, vision, values, and customer service standards of The MetroHealth System

Qualification

BillingCoding experienceRevenue cycle knowledgeMedical coding knowledgeCertifications in codingMicrosoft Office SuiteAnalytical skillsCommunication skills

Required

Bachelor's Degree in Business Administration, Healthcare Administration, Finance, or other related field, AND 2 years of billing, coding, and reimbursement experience

In lieu of degree, will consider 4 years of billing, coding, and reimbursement experience

Possesses one or more of the following certifications/license (applies to all hires effective 4/1/14 or later):

Registered Health Information Administrator (RHIA) from the American Health Information Management Association (AHIMA)

Registered Health Information Technician (RHIT) from AHIMA

Certified Coding Specialist (CCS) from AHIMA

Certified Coding Specialist – Physician-based (CCS-P) from AHIMA

Certified Professional Coder (CPC) from the American Academy of Professional Coders (AAPC)

Certified Outpatient Coder (COC) from the AAPC

License to practice as a Registered Nurse in the State of Ohio

Strong knowledge of medical coding (must include both ICD-9 and CPT-4 coding)

Demonstrated knowledge of the revenue cycle

Computer literate, including experience with the Microsoft Office Suite of software programs

Strong analytical skills

Strong written, verbal, and interpersonal communication skills

Preferred

Ability to review and interpret managed care contracts and other billing regulations

Demonstrated knowledge of coding and billing regulations for unique clinical areas (i.e. rehab, mental health, skilled nursing, dental, emergency transport, etc.)