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Revenue Integrity Specialist

Saratoga Springs, New York

Job Description

Salaried Full-Time Days This position ensures that the Charge Description Master (CDM) is current, compliant with rules and regulations specific to each payor group on an ongoing basis. The position requires excellent knowledge of CPT/HCPCs and Revenue Codes, CMS billing regulations and healthcare reimbursement. Ensures complete and timely charging by managing regulatory changes, providing education, performing audits and maximizing the capabilities of the CDM system. Works with department managers to facilitate CDM maintenance to ensure consistency and accuracy in the CDM, claims processing and data collection. Knowledge of DRGs and APCs. Knowledge of healthcare payment systems, including principles of contracting with both governmental agencies and commercial insurance companies.Skilled in Office Windows applications (Word, Excel, etc.) Understanding of Federal, State and local rules and guidelines as it pertains to hospital billing. Strong written and oral communication skills. Able to work in a team environment and with minimum supervision. Qualifications: Bachelor's degree in Accounting, Finance, Business or Health Administration, Public Health or a related discipline. Knowledge of managed care and third-party payer benefits designs and reimbursement requirements. Experience providing charge capture-related consulting service in the healthcare industry. Solid understanding of health care reimbursement methodologies, to include CPT, ICD, and DRG Coding as well as the information systems used for healthcare finance, billing and managed care processes. Proficient in Microsoft Office applications including Excel, Outlook, Word, and PowerPoint. Strong analytical skills with attention to detail and a high degree of accuracy and organization in order to produce reports, analysis and other detail as requested. Excellent writing, presentation and communication skills required. Demonstrated ability to manage multiple tasks/projects and work under pressure in order to meet deadlines. Excellent Computer, oral and written communication skills. Hospital/healthcare background.

Additional Requirements / Information

Job Capacity: Employee (full-time)
Minimum Education Level: See Job Description
Visa Sponsorship: No
Related Industries: Accounting