Revenue Integrity Specialist II (work from home Eastern United States)

Location:

Work from home (Pennsylvania)

Shift:

Days (United States of America)

Scheduled Weekly Hours:

40

Worker Type:

Regular

Exemption Status:

No

Job Summary:

​Provides the necessary functions to capture, analyze, monitor and reconcile hospital and professional charges. Executes and performs programs to ensure efficient operations of program to generate sufficient cash flow to support operations and strategic initiatives. Responsibilities include capturing revenue, edit resolution, adjustment functions, analyzing, monitoring of hospital and professional services. Works in conjunction with Clinical Operations staff to ensure timely capturing of revenue, identifies trends and/or omissions.

Job Duties:

• Knowledge of both hospital and professional charge capture and billing processes.
• Completes hospital and professional edits as assigned.
• Compare and analyze various documentation in the Electronic Medical Record (EMR) to determine appropriate solution for edit resolution.
• Performs the manual capture of hospital and professional charges; validating required information is present on form, logging and batching of charge documents, manual entry ensuring the capture of all required data elements accurately, completes batch reconciliation process and forwarding completed batches to Corporate Imaging for document retention.
• Performs self-pay adjustments as directed for specific service lines as required.
• Completion of hospital and professional charge corrections as required.
• Confers with the coders, providers, clinical operations, and Revenue Management Practice Consultants (RMPC) as applicable to gather missing data.
• Performs the above-mentioned activities of the revenue management to ensure cost effectiveness and organizational efficiency and to ensure correct submission of billing information to insurance companies and patients, with minimal amount of direct supervision.
• Communicates their functional activities to their manager, senior management as it relates to capturing of revenue, resolution of edits, high dollar charge activity, reconciliation, revenue enhancement, organizational profitability, customer service and revenue management results.
• Works in conjunction with other areas to ensure coordinated activities with respect to all revenue management needs.
• Involved, when required, in the development of various revenue management and strategic plans.
• Assists in the recruitment, orientation, and training of new specialists to further the department goals.
• Provides coverage and assists other team members in the completion of their assigned duties to ensure timely and accurate processing of charges.
• Performing overall departmental operating functions within pre-determined limits, ensuring operational efficiencies, and obtaining pre-determined performance and quality targets.
• Provides analysis to manager of trends and issues identified, offering solution recommendation when appropriate.
• Aids other departments on as-need basis which may involve additional training of skills/functionalities.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Position Details:

Internet requirements:

​Employee required to have/supply: Cable modem, (high speed, only - No DSL or Wireless Cellular Service or Satellite Service) The minimum requirement is:

• •25 MBPS UP
• •75 MBPS DOWN
• •<150 ms Ping Required
• •<30ms Jitter Required

Computer must be connected to the internet via Ethernet cable; wifi is not permitted unless a Virtual Private Network (VPN) is used for the wifi connection

Education:

High School Diploma or Equivalent (GED)- (Required)

Experience:

Minimum of 2 years-Related work experience (Required)

Certification(s) and License(s):

Skills:

Communication, Computer Literacy, Teamwork

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.

• KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
• EXCELLENCE: We treasure colleagues who humbly strive for excellence.
• LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
• INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
• SAFETY: We provide a safe environment for our patients and members and the Geisinger family. 

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all.  We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.