Become A Revenue Specialist

* Review and approval of new customer orders
* Data Entry of PMA contracts
* Review, update, create Customer Master information
* Calling customers to review contract specifications
* Provide field training as needed.
* Work with field office personnel and Order to Cash Management to identify process deficiencies and implement established best practices.
* Follow up and work with field operations utilizing risk and opportunities reports

* Under general supervision and following established practices, policies, and guidelines, provides Medicare outpatient billing & collections support to Patient Financial Services, performing duties which may include reviewing and submitting claims to third party payors, performing account follow-up activities, updating information on account, etc.
* Positions at this level require advance knowledge in specialized functions and full understanding of the revue cycle.
* Incumbents have expert knowledge and understanding of regulatory requirements, payor contracts and CSHS policies governing billing and collections and sound interpretation of same.
* Incumbents are expected to research, analyze and resolve problem accounts, may assist other team members.
* This position may be cross-trained in other revenue cycle functions and provide back-up coverage

* Manual captures of all inpatient and/or outpatient physician and hospital services provided in
* clinical or outreach facilities for appointed areas, and any outreach services from other institutions.
* Ensures that all necessary information is present on all paper charge documents.
* Runs various reports to ensure accuracy and completeness of charges.
* Confers with the coders, providers and/or Revenue Management Practice Consultants (RMPC) as applicable to gather any missing information.
* Based on established criteria, validates interface reports (Ingenious Med, CAM, EPIC to IDX, ARIA) to determine if there are any special instructions (i.e., special billing contracts, financial status classifications, insurance requirements, locations, research projects, state clinics, human services agencies, specialty billing matrix, etc.).
* Ensures all billable services from the Fatal Edit and Preprocessor Edit reports are accurately captured in appropriate billing system based on pre-determined criteria.
* Enters diagnosis and procedure codes based on pre-determined policy and procedures.
* Contacts coder, RMPC and/or physician for issue resolution.
* Escalates ongoing problem issues to Supervisor/Manager.
* Ensures all Revenue Capture workflows and policies are adhered to.
* Completes all outstanding Revenue Capture edits as assigned by Supervisor/Manager including TES, ETM, ePremis, and various HL7 edit reports.
* Completes charge document batching process.
* Confirms all documents are present as reported on department batch form.
* Performs data entry for prepared batches ensuring that all data elements are entered correctly.
* Completed batches are sent to Corporate Imaging.
* Provides analysis to Revenue Capture management staff of trends and issues identified while performing job functions.
* Also makes recommendations to correct issues identified.
* Ensures the maintenance of confidentiality for both the medical and financial information on patients who have received services from the Geisinger Health System.
* Performs all duties in a timely and accurate manner to ensure correct submission of billing information to insurance companies and/or patients, with minimal amount of direct supervision.
* Assist in the training and orientation of new Revenue Management Specialists to further the department goals.
* Assists and provides coverage for other pod team members in the completion of their assigned duties to ensure timely and accurate processing of charges.
* Participates in a minimum of 10 hours of online training, team meetings, in-services, etc. per year.
* Observes and supports Geisinger Health System policies.
* Required completion of all assigned GOALS courses.
* Performs other duties as required or assigned by emergency or other operational reasons for which the employee is qualified to perform.
* Denotes essential job functions

* Abstracts, interprets, classifies, posts and balances transactions to patient accounts based on information provided by health insurance and patient’s payments.
* Reviews, researches and resolves patient account payments with incomplete information.
* Performs a variety of data entry and balancing transactions in a multi-system environment requiring knowledge of several system-unique processes.
* Prepares various ancillary accounting reports as required.
* Maintains accurate and complete records of documents substantiating posted payments

* Revenue Integrity Specialists responsibilities include resolving billing errors in order to send claims to insurance companies for timely payment, working with coding and patient access departments to ensure compliant billing practices, providing additional documentation as needed to insurance companies, monitoring transfer of claims electronically to clearinghouse, working with Denials Management department to identify trends in billing errors, and identifying new claims edit needs to facilitate accurate billing.
* Performs other duties as assigned