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Revenue Integrity Specialist
Connecticut Children's. Support Connecticut Children’s Medical Center and Connecticut Children’s Specialty Group by improving revenue results across clinical and financial processes from scheduling through final bill generation .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in revenue cycle management, including coding, billing, and reimbursement processes, while providing training and support to clinical departments. Proficient in analyzing workflows to identify compliance issues and enhance revenue integrity.
Highest-signal resume keywords
CPC CertificationCCS CertificationRevenue Cycle ManagementMedical TerminologyCPT and ICD-10 Coding Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Professional Billing ExperienceRevenue Code KnowledgeNCCI EditsHCPCS Coding KnowledgeIPPS and OPPS UnderstandingClaim Billing KnowledgeHealthcare Applications Knowledge
Soft Skills
Interpersonal SkillsCommunication SkillsOrganizational SkillsProject Management SkillsCustomer Service Skills
Tools & Technologies
Microsoft WordMicrosoft Excel
Certifications & Qualifications
CPC CertificationCCS Certification
Industry Keywords
Revenue IntegrityDocumentation and Charge CaptureRegulatory StandardsContinuing Education
About the role
Key responsibilities & impact- Support Connecticut Children’s Medical Center and Connecticut Children’s Specialty Group by improving revenue results across clinical and financial processes from scheduling through final bill generation
- Participate in team huddles with professional coders and HIM and serve as a resource for professional coding staff
- Monitor processes to help ensure accurate coding, billing and reimbursement
- Evaluate and manage workflows for coding software systems and assist with implementation, education and training
- Implement and monitor workflows to identify revenue leakage, waste, compliance issues and root causes of noncompliance
- Provide guidance, communication, education and training on documentation and charge capture to providers and clinical departments
- Establish and oversee internal monitoring processes for documentation and charge capture
- Review and document trends, discrepancies, charging opportunities and documentation opportunities
- Assist with CPT updates and government billing and coding guideline reviews, coordinating updates with IT and stakeholders
- Participate in Revenue Integrity policy and procedure development and implementation
- Partner with Revenue Cycle, Finance and organizational stakeholders on service changes and expansions
- Participate in continuing education and maintain current credentials
Requirements
What you’ll need- High School Diploma, GED or equivalent required
- Minimum 3 years professional and/or facility billing experience required
- CPC or CCS Certification obtained within 1 year of hire into role
- Significant revenue code, Medical Terminology, CPT, ICD-10, NCCI Edits and HCPCS coding knowledge
- Solid understanding of IPPS, OPPS, and Fee Schedule reimbursement systems
- Working knowledge of payer policies and claim billing
- Working knowledge of multiple healthcare applications
- Basic knowledge of Microsoft Word and Excel
- Well-developed research, organizational and project management skills
- Excellent interpersonal, communication, customer service, oral, written and presentation skills
- Ability to prioritize multiple tasks and interpret and implement regulatory standards
Benefits
Comp & perks- Monday-Friday schedule, 8:00am-4:30pm
- Continuing education to enhance knowledge and skills and maintain current credentials