Revenue Integrity Specialist

Hazelden Betty Ford Foundation • San Diego, CA

2d • Hybrid

About The Position

The Revenue integrity Specialist is responsible for ensuring the accuracy, compliance, and optimization of revenue-related activities in a healthcare organization. They monitor billing processes, ensure accurate charging, identify areas of revenue leakage, and ensure compliance with healthcare regulations and payer policies. This role also involves educating staff, auditing records, and implementing improvements in systems and processes to protect the organization’s revenue stream.

Requirements

• Bachelor's degree or 6 years of equivalent related work experience or an associate's degree with 4 years of related work experience
• Three years of previous healthcare, insurance, or finance experience
• Knowledge of DRG, ICD, and CPT medical record coding and UB and HCFA 1500 claim billing strongly preferred.
• Previous experience with an Electronic Health Record or documentation.
• Intermediate mastery of Microsoft Office, including Excel

Nice To Haves

• Minimum of two years in healthcare revenue integrity

Responsibilities

• Review commercial payer policies, provider manuals and regulations to ensure compliance.
• Manage additions and changes to charges and claim rules.
• Identify opportunities for improvement.
• Assist with validation of data used in analysis.
• Perform Charge Reconciliation.
• Collaborate with other departments.

Benefits

• Competitive Health, Dental and Vision Plans
• Retirement savings plan with employer match
• Paid time-off
• Tuition reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees