Revenue Integrity Specialist
Job ID: 157736
Category: Clerical/Administrative
Work Type: FT
Location: Philadelphia, PA, United States
Date Posted: Oct 21, 2022
Work Schedule: Variable
Description
Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
Summary:
This position is responsible for supporting Radiology Revenue Cycle Operations (RRCO) as it relates to front end billing issues, billing exceptions and edits, insurance follow-up and all contracted payment accounts. The scope includes all professional and hospital Radiology Services (diagnostic, therapeutic, or surgical) performed or billed through Penn Medicine. Performs daily charge reconciliation and ensures all services are posted to the appropriate department in a timely manner. Work with all departments to maintain a high level of charge integrity, maintain expected charge lag, and enhance reimbursement and decrease denials.
Responsibilities:
• Utilize health system tools to monitor charges and edits to ensure timely and accurate reimbursement of services rendered.
• Provide support to front office staff to resolve patient issues. Accurately quote self-pay rates to patients as indicated by the entity guidelines.
• Enter charges and/or corrections into the appropriate system. Resolve all pre-billing claim edits within 2 business days
• Work closely with other teams to proactively identify and resolve issues or variances in expected volumes.
• Work directly with the leadership team to achieve strategic and operational objectives of the department.
• Support department leadership in maintaining a high level of charge data integrity. • Performs duties in accordance with Penn Medicine and entity values, policies, and procedures
• Other duties as assigned to support the unit, department, entity, and health system organization
Credentials:
Education or Equivalent Experience:
• H.S. Diploma/GED AND 3+ years Hospital or Practice Revenue Cycle Setting, working with insurance carriers and medical billing
OR
• Bachelor's Degree Healthcare, Finance, Management, or related AND 2+ years Hospital or Practice Revenue Cycle Setting, working with insurance carriers and medical billing
Live Your Life's Work
We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.
