Revenue Integrity Specialist

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☕ Washington – Remote

☕ Washington – Remote

💵 $88.8k - $133.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Seattle Children's

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1907

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

💰 $200k Grant on 2022-09

Healthcare • Healthcare Insurance • Non-profit

Seattle Children's is a leading children's hospital recognized as one of the top 10 best children's hospitals in the U. S. by U. S. News & World Report. Located in Seattle, Washington, this hospital provides comprehensive medical care and conducts groundbreaking research to improve treatments for over 200 diseases affecting children. Seattle Children's is committed to compassionate care and health equity, serving families across Washington, Alaska, Montana, and Idaho. The hospital offers various services including urgent care, psychiatric care, and specialized orthopedic care. Financial assistance is available for families needing help with medical expenses.

📋 Description

• Research and analyze coding-related denials and revenue flow interruptions • Identify patterns of payer behavior, coder trends, or system issues • Maintain denial work queues and perform hands-on remediation • Track escalations and communicate with Payer Relations and Hospital Billing teams • Provide revenue-related reporting using SlicerDicer and Reporting Workbench • Assist operational owners with charge reconciliation understanding • Serve as a subject matter expert on facility payment models and technical charge flow through Epic • Identify opportunities for automation and AI implementation to improve compliant revenue capture • Collaborate with coding educators and service line leaders to bridge clinical and revenue cycle processes

🎯 Requirements

• Associate degree in Health Information Management or related field or equivalent relevant work experience • Minimum of five years of experience in coding and abstracting clinical information in an acute care hospital setting or equivalent • Direct experience with both facility and professional coding practices and standards • Minimum one year of experience in a Revenue Integrity-related role • Certified Coding Specialist (CCS) certification by AHIMA, or Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) by AAPC • RHIT or RHIA willing to obtain a listed coding credential within 6 months of hire • Knowledge of facility payment models (DRG, APC, EAPG) • Technical charge flow through Epic for inpatient and outpatient services • Preferred: Bachelor’s degree • Preferred experience in an academic acute care setting • Preferred experience in a pediatric acute care setting • Preferred experience with EPIC • Preferred experience with SharePoint and instructional design • Preferred experience in coding denial management and appeals process • Preferred experience researching payer policy and coding guidelines • Preferred experience with decision support systems • Preferred experience with encoders (3M) • Adept use of Excel, Word, and PowerPoint

🏖️ Benefits

• Medical, dental, and vision plans • 403(b) • Life insurance • Paid time off • Tuition reimbursement