Revenue Integrity Technician

Primary Purpose

Responsible for identifying chargemaster charging issues, creating patient estimates, and helping implement solutions to assure accurate charging for services provided within the CDM.

MINIMUM SPECIFICATIONS

Education

• Must have an associate degree in accounting or healthcare related field.

Experience

• Must have at least one year experience in healthcare.

Equivalent Education and/or Experience

• May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.

Certification/Registration/Licensure

• None.

Required Tests for Placement

• Must be able to successfully pass the Intermediate-level Microsoft Excel test, as established by Workforce Planning & Recruitment, with a minimum score of 70%.

Skills or Special Abilities

• Must be able to successfully pass the Intermediate-level Microsoft Excel test, as established by Workforce Planning & Recruitment, with a minimum score of 70%.
• Must have oral and written communication skills.
• Must be proficient with computerized spreadsheet and word processing software.
• Must be proficient in Microsoft Office (Excel, Word, Outlook, Powerpoint)
• Position requires detailed-oriented individual, able to focus on details for long periods of time.
• Must be able to analyze data and make relevant use of the data.
• Must be able to understand and apply patient account coding and billing concepts, as they relate to Medicare and Medicaid reimbursement.
• Must have a working knowledge of hospital operations, strong computer skills, and understand patient and financial accounting systems.
• Applicant must possess strong computer skills, with knowledge of different databases, spreadsheets and word processing software.

Responsibilities

• Responsible for promoting adherence to applicable state/federal laws and regulations and the program requirements of federal, state, and private health plans through accurate and timely chargemaster database maintenance. With supervision, applies applicable laws and regulations as well as preserving documentation that supports their work product.
• Responsible for creation of patient estimate templates in billing software to ensure accurate patient estimates per regulatory requirements.
• With supervision, reduces risk to Parkland by producing an accurate work product that is able to withstand scrutiny by government payers and agencies. Reviews work product for errors, minimizing the potential for inaccuracies.
• Using internal and/or external tools, maintains the chargemaster database within the Epic patient accounting system.
• Serves as a resource to other hospital areas in resolving basic issues related to charging for services, providing patient estimates, billing rules and/or the chargemaster database.
• Supports data requests and audits, providing information requests in a timely manner.
• With supervision, reviews Epic work queues and resolves edits for account issues.
• Resolve accounts in assigned work queues timely.
• Supports special projects within their area of responsibility.
• Maintains positive working relationships with other hospital departments such as Patient Financial Services, Medical Records, Compliance, and Clinical areas to ensure that the responsibilities of the department are performed in an expeditious and thorough manner.
• Responsible for completing special projects as assigned by management team.

Job Accountabilities

• Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
• Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
• Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.