Revenue Integrity Specialist

Join to apply for the REVENUE INTEGRITY SPECIALIST role nards Healthcare

• College Graduate and/or 5+ years’ experience with revenue cycle operations.
• Requires 2-5 years of healthcare experience, preferably with knowledge of the reimbursement/denials process. Knowledge of ICD-10 & CPT coding and guidelines.
• Familiarity with reimbursement systems, Federal, State and payer-specific regulations pertaining to documentation and billing.
• Experience with coding, billing (UB-04 requirements), process management, leadership and interpersonal skills.
• Excellent written and verbal communication skills.
• Proficient in Excel, PowerPoint, Word and database applications.
• Ability to act independently and manage competing priorities, multi-task with results‑oriented outcomes in a fast‑paced environment.
• Meticulous follow‑up skills; experienced in working in a team environment.

• This is a safety‑sensitive position. See St. Bernards Substance Abuse Policy for further information.
• Normal hospital environment. Close eye work and hearing within normal range. Oral communication. Operates computer, fax, and copier. Long periods of sitting. Occasional walking, bending, climbing. May lift, carry, push, pull up to 5 pounds.

Responsible for aggregating and trending denial information according to discrete OP denial codes and work within denial software. Also works with IP denials. Analyzes information, assigns follow‑up responsibility. Works with clinical areas to decrease denials by coordinating monthly meetings with departments to discuss trends, opportunities, etc. Assists Revenue Integrity Coordinator with denial appeals and close out each tracked denial (overturned or recouped).

Overall works to increase revenue capture. Assists with Medical Center denials process as needed. Facility resource for denials/appeal process and regulatory compliance. Ability to manage competing priorities, multi‑task with results‑oriented outcomes and work in a fast‑paced environment. Requires independent judgment and critical thinking skills.

Entry level

Full-time

Accounting/Auditing and Finance

Hospitals and Health Care