Required Knowledge, skills and Abilities:
- Must have significant revenue code, CPT and HCPCS coding knowledge.
- Solid understanding of institutional and professional claim forms fields and values, multiple reimbursement systems including IPPS, OPPS, and Fee Schedule.
- Excellent interpersonal and communication skills to positively interact with a variety of hospital personnel, including administrative and management staff.
- Highly skilled experience and knowledge of Windows-based software required, including but not limited to Microsoft Windows, Outlook, Excel and Access.
- Possess effective oral and written skills, including advanced presentation skills.
- Well-developed research skills.
- Ability to interpret and implement regulatory standards.
- Working knowledge of multiple healthcare applications; Epic experience highly desired
- Knowledge of accurate sources for updating all applicable code sets (CPT/HCPCS, ICD-9, etc.) inclusive of associated edits such as NCCI.
- Excellent organizational and project management skills.
- Possess effective time management skills to permit handling of large workload.
- Bachelor’s Degree or equivalent work experience.
- Preferred Bachelor’s degree in Health Information Management or nursing
- At least 3 years minimum experience in healthcare finance, or CDM/Revenue integrity.
- Advance knowledge of EPIC charge description master (CDM), pricing, charge structure and processes.
- Two - Three years of experience n the healthcare industry with a working knowledge of hospital or physicians revenue cycle functions.
- Up to date working knowledge of Medicare billing regulations
- Up to date working knowledge of medical coding rules and regulations
- Working knowledge of current Medicare, Medicaid and other regulatory billing guidelines and requirements
- Understanding of Industry specific terminology
- Detailed knowledge of revenue cycle work streams and revenue flow
- Revenue cycle process management
- Significant systems expertise
- Comprehensive experience with facility and professional billing requirements
- Dual Hospital and Professional coding certifications preferred (CPC, CCP-H, CCS, CCSP)
- EPIC CDM certification or within one year.
- Preferred: RHIT credentials.
Conditions of Employment:
Baptist Memorial Healthcare Corporation Revenue Integrity Coordinator manages a significant volume of business and operations across multiple locations. Work priorities shift in response to fluctuating demands. Full time schedules are assumed to be at least 40 hours, however, incumbents are expected to remain flexible to accommodate the unit's goals and mission, and to work beyond their normal schedule when necessary. While this role will primarily be based in an office or home environment, there will be exposure to clinical areas and operations. Ability to provide transportation to travel as required to accomplish the goals of the unit.