Job Description:

Optim Health System is seeking a full time Revenue Integrity Specialist for our Savannah location. Candidates who do not live in the Savannah area are also welcome to apply as this position can be remote.

Job Requirements:

• Understands and adheres to the Optim Health Performance Standards, Policies and Behaviors.
• Assures the delivery of quality department /clinical services in accordance with established hospital and regulatory/accreditation agency standards.
• Responsible and accountable for the overall compliance of their assigned department.
• Assures employee compliance with hospital and Human Resources policies and procedures as well government regulations
• and guidelines.
• Assures competency and education requirements are satisfied as per hospital policy.
• As required, participates in the Performance Improvement Program as defined by the organization.
• Responsible for participation in committees, task forces and projects as appropriate.
• Assures the provision of a safe employee/patient environment.
• Maintains knowledge related to the operations of their department.
• Works collaboratively with all levels of the hospital interdisciplinary team and promotes the team concept within their department and hospital wide.
• Demonstrates positive customer service, fosters positive employee relations and assures that staff adhere to the Customer Service Behavioral Standards.
• Supports hospital initiatives and projects and functions as a positive change agent.
• Promotes a positive and professional image and is a role model, coach, mentor and resource for staff and peers.
• Ensures compliance with all regulatory standards and policies.
• Responsible for research and roll-out of federal and state updates pertaining to hospital and billing compliance.
• Works to protect revenue based upon regulatory compliance requirements.
• Responsible for analysis of audit findings to report to senior management findings and recommendations to prevent future loss as well as protect current revenue.
• Assists in educating staff and other departments regarding federal and state laws as it pertains to hospital procedures and billing guidelines.
• Assists in disseminating government updates to healthcare providers, ensuring necessary changes are made to processes, chargemaster, and/or billing process as required within the time frame for accurate and compliant billing.
• Works independently managing time lines, projects and audits to ensure compliance within required time frames and go live dates.
• Responsible for hospital enrollment and revalidation of government agencies.
• Handles billing office reporting to government agencies as required.
• Manages audits both external and internal as it pertains to the billing office.
• Communicates findings and overseeing corrective actions for audits within the operational units.
• Responsible for upkeep of the charge master and ensuring the compliance and integrity of the charges and billing.
• Performs charge master integrity audits as well as charge audits to ensure all revenue is captured appropriately at the account level and in the billing system.
• Reviews billing edits to ensure accurate and complete billing following regulatory requirements, to resolve and prevent future
• edits.

Optim Offers:

• Competitive Pay
• Company Benefits
• Vacation, Personal, and Sick Time Off
• Holiday Pay
• 401K Plan