at OSF HealthCare (Main Office) in East Peoria, Illinois, United States
Job Description
Overview
Expected pay for this position is $26.46 - $31.13/hour. Actual pay will be determined by experience, skills and internal equity.
POSITION SUMMARY:
The Revenue Integrity Project Specialist provides functional project support, collects and analyzes data and prepares project materials. Participates in and assists with project implementations including training. Provides support by tracking milestones and completion of tasks and follow up. Tracks meaningful project metrics and key performance indicators related to denial management, avoidable write-offs (AWO) prevention, and payment variance in a tracking portal to show sustainable results and net dollars captured. Assists with the interpretation of metrics and reporting, and regular communication with departments and external stakeholders on both operational and technical improvement areas. The Specialist quantifies trends and measures opportunities to increase net revenue and assists with source identification and root cause resolution of denials and payment variance. The position requires high level of customer service skills to establish and enhance positive relationships with Revenue Integrity, Revenue Cycle Operations, IT, Finance, and other stakeholder departments.
Qualifications
REQUIRED QUALIFICATIONS:
Education:
* Associate's Degree or equivalent experience of 2 years in a healthcare or public health setting with one of a combination of the following: patient finance, insurance benefits, financial assistance programs, public health.
Experience:
* Six (6) months experience in healthcare collection, financial counseling, insurance benefit verification and/or precertification, third party payor, Medicaid case work, admitting or billing, or other hospital services.
* CRCR (Certified Revenue Cycle Representative) required within year of hire.
Other skills/knowledge:
* Excellent ability to understand and interpret statistical reports and perform quantitative analysis.
* Advanced skills in problem solving in a variety of settings and translation of data into actionable steps.
* Strong understanding of managed care fundamentals and denial resolution processes for both hospital and billing claims.
* Knowledge of the principles of Information Systems in order to effectively analyze and make decisions.
* Proficiency in Microsoft Suite software
PREFERRED QUALIFICATIONS:
* Bachelor's Degree in Healthcare, Accounting, Business Administration, or related field
* Proficiency in EPIC
OSF HealthCare is an Equal Opportunity Employer.
EOE
