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Revenue Integrity Specialist - Corporate

  • Job ID: 360180487
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Corporate Revenue Cycle
  • Department: Rev Cyc IOT
  • Location: 1201 Grampian Boulevard, Williamsport PA 17701
  • Union Position: No
  • Salary Range: $35.90 to $53.86 / hour

Description

UPMC Corporate Revenue Cycle is hiring a Revenue Integrity Specialist to join our team!  This role will work out of Williamsport, PA with the potential of overnight travel based on project work.

The Revenue Integrity Specialist will maintain and enhance the revenue cycle process for assigned business unit(s). They will assist with financial analysis and reporting, coordinate investigations and audits, and assist to establish policies and procedures.  The candidate will also provide senior staff support to the Chief Financial Officer in relation to various goals and initiatives of the Accounts Receivable and Accounting Departments.

If you are someone who enjoys project management and has prior knowledge of Epic/Medipac, then this could be the job for you!  Apply today!

Responsibilities:
  • Maintain current industry knowledge and trends, attend educational events, acquire certification and participate in committee work as appropriate. Participate in hospital initiatives such as new technology, new programming, denial management, and revenue cycle issues.
  • Review results of compliance monitoring including internal audits and external compliance audits.
  • Establish monitoring mechanisms to keep abreast of regulatory changes and communicate such changes to management as necessary.
  • Develop and manage various financial/operational trend reports outlining key indicators for achievement of financial performance goals.
  • Assist with programmatic financial analysis, problem solving in relation to managing different aspects of the revenue cycle and investigating related to billing compliance and regulatory issues.
  • Maintain awareness of new or revised laws and regulations affecting the organization and assures training, education.
  • Demonstrate open and on-going communications with other departments, payers, vendors to assure positive customer service environment.
  • Review payer denials and coordinate with appropriate department process/documentation to reduce denials.
  • Ensure that charging procedures are in compliance with regulatory agencies and provide recapture of entitled reimbursement.
  • Assist in planning, developing and conducting educational and training sessions related to specific compliance topics.
  • Dissemination of materials, etc., to affected staff and development of new or revised policies and procedures as appropriate.
  • Assist in establishing policies and procedures in support of compliance and ethics activities.
  • Responsible for maintaining and enhancing the revenue cycle process across the organization.
  • Work collaboratively with other leaders to achieve department and hospital-wide quality, satisfaction and financial goals.
  • Assist with programmatic financial analysis, problem solving in relation to managing different aspects of the revenue cycle and investigating related to billing compliance and regulatory issues.
  • Review and develop processes and systems to improve financial performance and generate cash flow.
  • Function as liaison between the Central Billing Office and clinical departments to optimize charge capture.
  • Keep abreast of all healthcare changes as well as third party regulations and ensure updates to systems, policies and procedures are implemented.
  • Ensure that charging procedures are in compliance with regulatory agencies and provide recapture of entitled reimbursement.
  • Coordinate development of corrective action plans to minimize risk of non-compliance or address areas of non-compliance.
  • Coordinate responses to audits and investigations of legal compliance matters by state or federal agencies in conjunction with legal counsel, chief financial officer and other appropriate individuals.
  • Initiate monitoring and conduct periodic audits of processes throughout the organization as needed.

Qualifications

  • Bachelor’s degree in Healthcare Management, Finance, Business Administration or related field, OR
  • Five years’ experience in patient accounting, hospital/physician office operations OR
  • Four years of progressive experience of Revenue Cycle within a professional billing or health care environment, or an equivalent combination of education and experience required.
  • Five-seven years of experience in patient accounting or other financial environment.
  • Clinical experience preferred.
  • CPA preferred.

Licensure, Certifications, and Clearances:
  • Act 34 criminal clearance

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life &emdash; because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

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