Revenue Integrity Specialist II (NJ/PA Residents only)

Hunterdon Healthcare

  • Flemington, NJ
  • $80,404-100,505 per year
  • Permanent
  • Full-time
  • 2 months ago
Position Summary
  • Supports Hunterdon Medical Group (HMG) with overall revenue optimization, to include, but not limited to, charge capture; CPT/RVU code assignment; payer bulletin interpretations; and denials avoidance. This position will collaborate with all physician practices and leadership to ensure accuracy with all revenue cycle processes. This role will lead payer specific audits to ensure accurate and timely payment around new programs and practice plan growth and development. Completes assigned reporting timely and accurately and participates in all revenue cycle task force opportunities, as assigned.
Primary Position Responsibilities
  • Responsible for the overall maintenance and set-up of the NextGen Service Item Master (SIM) to include, assignment of new CPT/RVU codes, pricing, and system testing/validation.
  • Lead inter and intra-departmental teams on denial investigations and root cause analysis; including identifying opportunities for denial prevention through the revenue cycle.
  • Maintains an understanding of regulatory and payer changes to ensure correct charging and billing requirements are met.
  • Maintains working knowledge of coding and billing regulations for all payers. Keeps current on regulatory updates, local payer policies and procedures to ensure charge accuracy, compliance, and optimization.
  • Serves as liaison for HMG revenue cycle opportunities being evaluated by practice operations and leadership.
  • Works with Central Business Office on specific payer requests and/or claim adjudication.
  • Other duties as assigned.
Qualifications
  • Minimum Education:
  • Required:
  • Associate Degree
  • Preferred:
  • Bachelor's Degree
Minimum Years of Experience (Amount, Type and Variation):
  • Required:
  • 3-5 years, specifically in revenue cycle; contract management support; documentation; billing and denials management with a focus in Physician Practice Management
  • Preferred:
License, Registry or Certification:
  • Required:
  • American Association of Professional Coders/Certified Professional Coder
  • Preferred:
Knowledge, Skills and/or Abilities:
  • Required:
  • Strong understanding of healthcare reimbursement methodologies (eg., fee-for-service, value-based payment models)
  • Preferred:
  • Proficient in revenue cycle systems (NextGen, EPIC) and reporting tools
Hunterdon Health is committed to providing a competitive benefit package to our employees. Benefit offerings vary based on status and may include but not be limited to medical, dental, vision, family forming, paid time off, tuition reimbursement, and retirement savings.The hiring range listed is the potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement. When determining an applicant’s hourly rate and/or base salary, several factors may be considered as applicable (e.g., years of relevant experience, education, internal equity, and specialty).Post JobAdditional Info:Hunterdon Medical Center, in Flemington, NJ, treats over 8,000 inpatients annually, with nearly 30,000 Emergency Department visits and over 590,000 outpatient visits per year. The 178-bed teaching hospital provides a full range of preventive, diagnostic and therapeutic inpatient and outpatient hospital and community health services. Hunterdon County has been ranked as one of the best places to raise a family and noted for the top-notch school system.Hunterdon Health offers a family like work environment, competitive salary and benefits and opportunities for personal growth and development. The organization has a long-standing commitment to excellence, consistently striving to be a national model for community health care.

Hunterdon Healthcare