Revenue Integrity Liaison
Job in
Lincoln, Lancaster County, Nebraska, 68511, USA
Listing for:
Bryan Health
Full Time
position
Listed on 2026-02-17
Job specializations:
-
Healthcare
Healthcare Administration, Medical Billing and Coding, Healthcare Management, Healthcare Compliance
Salary/Wage Range or Industry Benchmark: 80000 - 100000 USD Yearly
USD
80000.00
100000.00
YEAR
Job Description & How to Apply Below
GENERAL SUMMARY
Serves as the liaison between the revenue cycle management departments and the hospital and ambulatory departments. Responsible for collaborating with department revenue leads and staff to ensure accurate charge capture operations are in place to include daily charge capture, revenue reconciliation and error correction processes. Maintains collaborative relationships with Patient Financial Services, Clinical Departments, and Compliance. Plays an important role with improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation.
PRINCIPAL
JOB FUNCTIONS
* Commits to the mission, vision, beliefs and consistently demonstrates our core values.* Monitors transactions in the charge review work queues and follows up with departments on backlogs, threshold change request and other charge issues.Researches and resolves claim pre-bill edits and pre-bill errors within the assigned queue, including review and correction of the daily assigned DNFB hold claims.Applies NCCI and MUE guidelines to resolve edits appropriately and identify any charging or compliance issues. Coordinates with coding and clinical areas to resolve any identified charging issues.* Responsible for verification and/or correction of billing data for accuracy and completeness by following regulatory requirements and reviewing the medical record.Coordinates findings with hospital departments to ensure missed charges are billed. Collaborates with departments on developing process changes to ensure accurate, compliant and efficient charging practices.* Analyzes the charge review work queues to identifying root causes. Educates clinical staff and department leaders of missed charges or incomplete documentation, which does not support billed charges.* Works with identified clinical and revenue cycle departments to implement compliant process changes.* Meets independently with Directors regarding charging, reconciliation and compliance concerns.* Updates and maintains department charge master as needed including: performing charge master maintenance and validating entries; reviewing and assisting with maintenance of charge master compliance reports; assisting with other necessary projects to maintain the charge master file; and working with clinical areas to update charge master for annual cpt/hcpcs code changes.* Performs patient audits to ensure correct charging and review all external outpatient accounts with external auditors. Leads audit/charge evaluations according to the Manager of Revenue Integrity. Meets with departmental leadership to review findings, documentation standards and recommendations for improvement.* Serves as a liaison between Facility Administration, Department Director, and external auditors regarding charging issues, clinical documentation issues, and revenue opportunities. Builds strong relationships and facilitates productive communication between assigned department Directors, Managers, and staff. Collaborates to develop and implement action plans to resolve charge errors.* Reviews CMS transmittals and Local Coverage Determination (LCD) and assesses impact to Revenue Integrity procedures and implement. Regularly reviews literature to identify enhancement to the quality assurance methodology and documentation requirements.* Maintains in-depth knowledge of Medicare and Medicaid billing practices, guidelines, laws and regulations to ensure accurate Medicare and Medicaid billing. Reviews and interprets Medicare Local Coverage Determinations and National Coverage Determinations (LCD and NCD) and applies that to the billing process.* Assists Analytics when justification is necessary for unfavorable metrics. Must have the ability to analyze data in Excel or other Epic tools to help with variance analysis.* Utilizes established reporting analytics to monitor department's revenue cycle flow.* Maintains billing and coding education, attends webcasts and conference calls as required.Utilizes process improvement by continuously reviewing, recommending and implementing improvement steps; researching…
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