Revenue Integrity Specialist II - Arkansas Children's
Little Rock, AR
About the Job
Work Shift:
Please see job description for details.
Time Type:
Full time
Department:
CC017086 Cost Accounting and Revenue Integrity
Summary:
M-F Days
The Revenue Integrity Specialist performs intermediate daily monitoring and reporting analysis related to the revenue cycle. Recommends modifications to established practices and procedures or system functionality as needed to support revenue cycle. The analyst will work with internal customers to ensure newly implemented workflows and procedures support revenue cycle integrity and to achieve revenue cycle’s financial goals. Communicates any issues to the Director of Cost Accounting & Revenue Integrity. Conducts charge capture audits to identify revenue leakage and charge accuracy. Assists with the maintenance of an accurate and complete charge master ensuring appropriate reimbursement and compliance with governmental billing regulations. Maintains working knowledge of CPT and HCPCS coding as well as billing and other relevant coding/ billing guidelines. Performs special projects and analysis as needed.
Additional Information:
Required Education:
Recommended Education:
Bachelor's degree from four-year college or university; Or four years related experience and/or training; or equivalent combination of education and experience.
Required Work Experience:
Recommended Work Experience:
Related Field - 3 years of experience
Required Certifications:
Certified Inpatient Coder (CIC) - American Academy of Professional Coders (AAPC)
Recommended Certifications:
Description
1. Oversees charge capture and reconciliation processes and provides education for new services added. Works with various departments to ensure appropriate charge capture. Conducts charge capture audits to identify revenue leakage and charge accuracy.
2. Works with internal customers to ensure newly implemented workflows and procedures support revenue cycle integrity and achieve the revenue cycle's financial goals. Collaborates with IT to ensure all cross walk, mapping, interfaces, etc. are set up correctly for appropriate charge capture and billing. Participates on various committees for changes designed to automate, optimize, and enhance revenue cycle integrity.
3. Performs daily review of charge items and revenue integrity work queues to ensure accurate and timely resolutions.
4. Performs appropriate follow-ups when unusual items are noted and ensure problems are resolved and prevented in the future.
5. Performs audits of tests/procedures performed vs. items reported in Hospital Information System to ensure daily charge reconciliations are accurate.
6. Responsible for the accuracy and timely setup and maintenance of patient charges for CPT code integrity in compliance of regulatory guidelines along with the consistency and integrity of pricing methodology. Performs annual update of CPT codes for assigned departments to ensure compliance with regulatory guidelines.
7. Coordinates with assigned hospital department heads to gain understanding of clinical services provided and interpret into patient charges.
8. Performs analysis of market data to ensure competitiveness of new and existing patient charges.
9. Performs analysis of issues involving charge set up for new and existing patient charges, investigate causes, propose solutions and reports findings to Cost Accounting Director.
10. Assists with the maintenance and accuracy of the cost accounting system by coordinating with assigned hospital department heads to gain understanding of clinical services provided and interpret into financial standard costs.
11. Assists with the accurate and timely setup and maintenance of the procedural standard costs components in the Strata Cost Accounting System.
12. Other Duties as assigned.
Arkansas Children’s (https://www.archildrens.org/about-us) is the only hospital system in the state dedicated to caring for children, which enables us to uniquely shape the landscape of pediatric care in Arkansas.
Arkansas Children’s is driven by four core values—safety, teamwork, compassion and excellence—which inform every action.
Arkansas Children’s Hospital has received Magnet Status (https://www.archildrens.org/about-us/magnet-recognition) from the American Nurses Credentialing Center (ANCC), for nursing excellence and patient outcomes. And we are nationally ranked by U.S. News & World Report (https://www.archildrens.org/about-us/awards-and-recognition) for Cancer, Cardiology & Heart Surgery, Diabetes & Endocrinology, Nephrology, Neurology & Neurosurgery, Pulmonology & Lung Surgery and Urology.
For more than a century, Arkansas Children’s has met the unique needs of children. But we’re more than just a hospital treating sick kids—our services include two hospitals, a pediatric research institute, foundation, clinics, education and outreach, all with an unyielding commitment to making children better today and healthier tomorrow.
Arkansas Children’s Little Rock campus includes a 336-bed hospital with the state’s only pediatric Level 1 Trauma Center, burn center, Level 4 neonatal intensive care and pediatric intensive care, as well as a nationally-recognized transport service. And Arkansas Children’s Northwest (https://www.archildrens.org/locations/arkansas-childrens-nw) provides inpatient and emergency care, clinic rooms and diagnostic services to children in that corner of the state.
_“Arkansas Children’s is a place of hope and comfort for children and parents. When you are at children’s, you are part of an elite team united with a common goal of saving children and making their lives better.”_ Michael – Business Operations Manager
“Arkansas Children’s Hospital is a prestigious institution that cares for children.” Linda – Information Systems Analyst
“We are an organization of care, love, and hope while we champion children.” Angela – Parking and Fleet Coordinator
“Care, love, and hope for children!” Kathy – Administrative Assistant
“When I think of my time here at Arkansas Children’s Hospital, I can honestly say that it has given me a unique perspective on the human condition, and the various roles that we all have in patient care. As a supply assistant, I have a very important job ensuring that the doctors and nurses have what they need to provide the world class medical care to the Children of Arkansas and surrounding states. Being a Champion for Children is more than a catch phrase, it is a way of life!” Nick – Supply Assistant
Arkansas Children's provides equal employment opportunity to all persons without regard to age, race, color, religion, national origin or citizenship status, disability, military status, sexual orientation, gender identity or expression, pregnancy or any other category protected by federal, state and local laws. Further, Arkansas Children's will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
Please see job description for details.
Time Type:
Full time
Department:
CC017086 Cost Accounting and Revenue Integrity
Summary:
M-F Days
The Revenue Integrity Specialist performs intermediate daily monitoring and reporting analysis related to the revenue cycle. Recommends modifications to established practices and procedures or system functionality as needed to support revenue cycle. The analyst will work with internal customers to ensure newly implemented workflows and procedures support revenue cycle integrity and to achieve revenue cycle’s financial goals. Communicates any issues to the Director of Cost Accounting & Revenue Integrity. Conducts charge capture audits to identify revenue leakage and charge accuracy. Assists with the maintenance of an accurate and complete charge master ensuring appropriate reimbursement and compliance with governmental billing regulations. Maintains working knowledge of CPT and HCPCS coding as well as billing and other relevant coding/ billing guidelines. Performs special projects and analysis as needed.
Additional Information:
Required Education:
Recommended Education:
Bachelor's degree from four-year college or university; Or four years related experience and/or training; or equivalent combination of education and experience.
Required Work Experience:
Recommended Work Experience:
Related Field - 3 years of experience
Required Certifications:
Certified Inpatient Coder (CIC) - American Academy of Professional Coders (AAPC)
Recommended Certifications:
Description
1. Oversees charge capture and reconciliation processes and provides education for new services added. Works with various departments to ensure appropriate charge capture. Conducts charge capture audits to identify revenue leakage and charge accuracy.
2. Works with internal customers to ensure newly implemented workflows and procedures support revenue cycle integrity and achieve the revenue cycle's financial goals. Collaborates with IT to ensure all cross walk, mapping, interfaces, etc. are set up correctly for appropriate charge capture and billing. Participates on various committees for changes designed to automate, optimize, and enhance revenue cycle integrity.
3. Performs daily review of charge items and revenue integrity work queues to ensure accurate and timely resolutions.
4. Performs appropriate follow-ups when unusual items are noted and ensure problems are resolved and prevented in the future.
5. Performs audits of tests/procedures performed vs. items reported in Hospital Information System to ensure daily charge reconciliations are accurate.
6. Responsible for the accuracy and timely setup and maintenance of patient charges for CPT code integrity in compliance of regulatory guidelines along with the consistency and integrity of pricing methodology. Performs annual update of CPT codes for assigned departments to ensure compliance with regulatory guidelines.
7. Coordinates with assigned hospital department heads to gain understanding of clinical services provided and interpret into patient charges.
8. Performs analysis of market data to ensure competitiveness of new and existing patient charges.
9. Performs analysis of issues involving charge set up for new and existing patient charges, investigate causes, propose solutions and reports findings to Cost Accounting Director.
10. Assists with the maintenance and accuracy of the cost accounting system by coordinating with assigned hospital department heads to gain understanding of clinical services provided and interpret into financial standard costs.
11. Assists with the accurate and timely setup and maintenance of the procedural standard costs components in the Strata Cost Accounting System.
12. Other Duties as assigned.
Arkansas Children’s (https://www.archildrens.org/about-us) is the only hospital system in the state dedicated to caring for children, which enables us to uniquely shape the landscape of pediatric care in Arkansas.
Arkansas Children’s is driven by four core values—safety, teamwork, compassion and excellence—which inform every action.
Arkansas Children’s Hospital has received Magnet Status (https://www.archildrens.org/about-us/magnet-recognition) from the American Nurses Credentialing Center (ANCC), for nursing excellence and patient outcomes. And we are nationally ranked by U.S. News & World Report (https://www.archildrens.org/about-us/awards-and-recognition) for Cancer, Cardiology & Heart Surgery, Diabetes & Endocrinology, Nephrology, Neurology & Neurosurgery, Pulmonology & Lung Surgery and Urology.
For more than a century, Arkansas Children’s has met the unique needs of children. But we’re more than just a hospital treating sick kids—our services include two hospitals, a pediatric research institute, foundation, clinics, education and outreach, all with an unyielding commitment to making children better today and healthier tomorrow.
Arkansas Children’s Little Rock campus includes a 336-bed hospital with the state’s only pediatric Level 1 Trauma Center, burn center, Level 4 neonatal intensive care and pediatric intensive care, as well as a nationally-recognized transport service. And Arkansas Children’s Northwest (https://www.archildrens.org/locations/arkansas-childrens-nw) provides inpatient and emergency care, clinic rooms and diagnostic services to children in that corner of the state.
_“Arkansas Children’s is a place of hope and comfort for children and parents. When you are at children’s, you are part of an elite team united with a common goal of saving children and making their lives better.”_ Michael – Business Operations Manager
“Arkansas Children’s Hospital is a prestigious institution that cares for children.” Linda – Information Systems Analyst
“We are an organization of care, love, and hope while we champion children.” Angela – Parking and Fleet Coordinator
“Care, love, and hope for children!” Kathy – Administrative Assistant
“When I think of my time here at Arkansas Children’s Hospital, I can honestly say that it has given me a unique perspective on the human condition, and the various roles that we all have in patient care. As a supply assistant, I have a very important job ensuring that the doctors and nurses have what they need to provide the world class medical care to the Children of Arkansas and surrounding states. Being a Champion for Children is more than a catch phrase, it is a way of life!” Nick – Supply Assistant
Arkansas Children's provides equal employment opportunity to all persons without regard to age, race, color, religion, national origin or citizenship status, disability, military status, sexual orientation, gender identity or expression, pregnancy or any other category protected by federal, state and local laws. Further, Arkansas Children's will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
Source : Arkansas Children's