Claims Review Specialist - Accounting/ Revenue Integrity Analyst

REQUIRED EXPERIENCE:Take on a significant role within a world-class health organization. Elevate the operational and financial effectiveness of a complex health system. Take your professional expertise to the next level.You will leverage your extensive theoretical revenue cycle knowledge as you take on a vast range of critical revenue issues. This will involve applying dashboards and processes for continuous analysis of complex revenue cycle functions while also auditing data input for all components of revenue cycle management. You will:Analyze complex financial dataIdentify trends in revenue cycle operationsSummarize data and present reports to leadershipServe as liaison with departments to thoroughly define reporting and information requirementsEvaluate revenue cycle workflows to identify areas for improvementOversee charge integrity, reconciliation, and charge linkages from ancillary charging systemsTrain patient financial services units on revenue cycle systems, processes and proceduresMaintain compliance with government regulations, reimbursement issues, etc.Analyze hospital billing claims within the EHR and claim scrubber systemResolve claim errors, edits, and other holdsWork with clinical and ancillary operational departments on correct coding, billing, and charging principlesWe're seeking a highly analytical, detail-driven professional with:Bachelor's degree in business, finance or related fieldCPC-H, CPC, or CCS coding certificationFive or more years of experience with hospital billing systems and third-party billing requirementsExperience in revenue integrity operations, clinical charge capture, charge master, or revenue cycle operationsProficiency with Microsoft ExcelKnowledge of Tableau Reporting dashboardsUnderstanding of Medicare/Medi-Cal claims processing guidelinesExperience with EPIC EHR, Cirius Claim Scrubber, or other EHR systemIn-depth knowledge of the practices, procedures, and concepts of the healthcare revenue cycleStrong analytical and problem-solving abilitiesExcellent communication, interpersonal, and collaboration skillsProficiency in the use of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and revenue codes

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