Revenue Integrity Analyst

Location: Remote - Florida

Department: Department of Revenue Integrity

Work Type: Full Time

Shift: Shift 1/7:00:00AM to 3:30:00AM

Minimum to Midpoint Pay Rate:$22.78 - $29.62 / hour

SummaryResolves billing issues, and provides coverage guidelines for billable services to reduce or prevent future claim denials. Employs Craneware Online, EPIC WQ workflows, and other accredited resources for assigned cost center(s) to identify potential reimbursement opportunities in a proactive manner. Ensures the appropriate bundling or unbundling of charges, and applicable modifiers applied so that all charges that are submitted result in optimal reimbursement while following applicable billing, coding and reimbursement regulations within respective areas. Interacts with other departmental staff, i.e. BO, HIM and ADT for resolution of third party payer billing disputes. Additionally, resolves CCI edits as appropriate, reviews Medicare intermediary and other third party payer bulletins to keep current on billing requirements and APC payment status and changes. Communicates relevant information to all applicable department personnel. Communicates results through daily interaction and monthly status meeting to the department team. Provides other support as needed. Requirements Educational Requirements Degree/Diploma Obtained Program of Study Required/
Preferred and/or High School Diploma or Equivalent Required Additional RequirementsPrefer Bachelor Degree or higher formal education, 2 years formal education post high school in clinical, financial, or coding program.Experience RequirementsMinimum Years RequiredArea of ExperienceRequired/
Preferred and/or3 YearsHealthcareRequired Additional Requirements3 experience in healthcare-related field, in hospital billing, coding and/or charging/reimbursement-related capacity. Additional clinical experience in related field a plus.State of Florida Licensure RequirementsLicenses Required/
Preferred and/or Not Required Certifications/Registration RequirementsCertificates/Registrations Required/
Preferred and/or Additional RequirementsCoding certification preferred to include CPT, HCPCS, ICD9-10, and DRG

US:FL:Fort Myers