Revenue Integrity Specialist - Los Angeles - Currance

Description

At Currance, we believe in recognizing the unique skills and experiences that each candidate brings to our team. Our overall compensation package is competitive and is determined by a combination of your experience in the industry and your knowledge of revenue cycle operations. We are committed to offering a rewarding environment that aligns with both individual contributions and our company goals.

Benefits include paid time off, 401(k) plan, health insurance (medical, dental, and vision), life insurance, paid holidays, training and development opportunities, a focus on wellness and support for work-life balance, and more.

Please note that we are looking for people who have hospital billing experience in collections and have some HB billing experience, in high dollar collections, adjustments and denials management.

Job Overview

This position is responsible for supporting Revenue Cycle Operations as it relates to front end billing issues, billing exceptions, and edits, insurance follow-up, and all contracted payor accounts. The scope includes all professional and hospital services (diagnostic, therapeutic, or surgical) performed or billed. This position performs daily charge reconciliation and ensures all services are posted to the appropriate department in a timely manner. This position will also work with all departments to maintain a high level of charge integrity, maintain expected charge lag, and enhance reimbursement and decrease denials.

Job Duties And Responsibilities

• Must be onsite M-F, full time at HPMC
• Utilizes health system and external system tools to monitor charges and edits to ensure timely and accurate reimbursement of services rendered.
• Conducts ongoing Charge Master activities (reviews, consolidation, revenue routing, etc.) to ensure compliance with Federal guidelines.
• Enters charges and/or corrections into the appropriate system. Resolve all pre-billing edits and reconcile charge reports within the defined statement of work.
• Prepares and analyzes reports on a regular basis for governmental and regulatory data, including Medicare Bad Debt and Medicare Credit Balance, and works with the leadership to help resolve any related issues.
• Establishes and maintains access within the payer proprietary portals, clearinghouses, and any client specific websites required by the Revenue Cycle and financial team members.
• Collaborate 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.
• Maintain strict confidentiality and adhere to all HIPAA regulations in handling financial and patient information.

Requirements

Qualifications

• Bachelors degree in Revenue Cycle Management or related field preferred.
• 3 years of experience working with hospital charge master.
• Experience with multiple host systems and Charge Master software.
• Expertise with computers including Microsoft Office Suite/Teams and GoToMeeting/Zoom, etc.
• Complete the HFMA Certified Revenue Cycle Representative (CRCR) within the first 90 days of employment.

Knowledge, Skills, And Abilities

• Knowledge of ICD-10 Diagnosis and procedure codes and CPT/HCPCS codes
• Knowledge of rules and regulations relative to Healthcare Revenue Cycle administration
• Skilled in medical accounts investigation.
• Skilled in achieving results with little to no oversight.
• Skilled to investigate and resolve escalated claims
• Skilled in research to identify new rules and regulations relative to Healthcare Revenue Cycle administration
• Ability to validate payments
• Ability to make decisions and take action.
• Ability to maintain a positive outlook, pleasant demeanor, mature nature during all interactions, and act in the best interest of the organization and the client.
• Ability to take professional responsibility for quality and timeliness of work product.

Disclosure Statement

As part of the Currance application and hiring experience, all candidates are subject to a criminal background check and a government exclusion check. The government exclusion check is a mandatory screening process that verifies whether an individual is listed on federal or state exclusion or watchlists, including but not limited to, the Office of Inspector Generals List of Excluded Individuals/Entities (LEIE) and the System for Award Management ).

These screenings are conducted to ensure compliance with applicable federal and state laws and regulations, to protect the integrity of federally funded programs, the clients we support, and to prevent participation by individuals who are excluded due to fraud, abuse, or other misconduct. By submitting an application, candidates acknowledge and consent to these checks as a condition of employment or engagement.