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RN Revenue Integrity

Job ID: 4667857
Updated: October 2, 2018
Geographic Location: 
Department: Revenue Cycle Integrity
Full/Part Time: Full-Time
Shift: Days
Standard Hours: 40
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Job Summary

This position is located onsite with Mercy Health, a client of Ensemble Health Partners. To learn more about Mercy, click the link below to apply.

Brief Description:

The Revenue Integrity Nurse performs all clinically related revenue integrity activities across the organization. Job duties include, but are not limited to, resolving clinically related billing errors in order to send claims to insurance companies for timely payment, acting as liaison between healthcare providers and billing department for any additional documentation needs, perform charge audits by reviewing medical documentation, identifying trends in clinical billing errors and recommendations for improvement, summarizing educational opportunities for healthcare providers based on audits, reviewing the charge description master (CDM) on a regular basis, and performing ad hoc clinical audit requests.                                     

Mission/Core Values:  

It is expected that all of the duties and responsibilities of this position will be performed in a manner consistent with the Ministry’s Standards of Behavior (CARE; Compassion: seeks to understand, listen and explain; Advocate: is the voice for the vulnerable;  Respect: demonstrates the highest regard for and welcomes all people; Excellence: commits to the highest standard of quality care, joyful service, and teamwork) and in a manner that reflects our core values which are: Excellence, Human Dignity, Justice, Compassion, Sacredness of Life and Service. All supervisors and above are expected to model the organizational mission and values through their daily actions, decision making and priority setting. All supervisors and above are expected to develop, implement and monitor short and long range plans to meet or surpass standards consistent with the overall strategic plan.

Responsibilities:

  • Revenue Integrity Nurse responsibilities include resolving clinically related billing errors in order to send claims to insurance companies for timely payment, acting as liaison between healthcare providers and billing department for any additional documentation needs, perform charge audits by reviewing medical documentation, identifying trends in clinical billing errors and recommendations for improvement, summarizing educational opportunities for healthcare providers based on audits, reviewing the charge description master (CDM) on a regular basis, and performing ad hoc clinical audit requests.
  • Performs other duties as assigned 

Qualifications:

  • 4 year Bachelor’s Degree
  • 3-4 years experience in healthcare industry.
  • Experience in physician and hospital operations, compliance and provider relations preferred.
  • Combination of post-secondary education and experience will be considered in lieu of degree

Hours

Full-time, 40 hours per week, days, 8:00 a.m. to 5:00 p.m.

Equal Employment Opportunity

It is our policy to  abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.

About Us

This position will be a part of the revenue cycle team at Ensemble Health Partners - a wholly owned subsidiary of Mercy Health. Ensemble Health Partners specializes in providing revenue cycle solutions and creating real value for its clients by building relationships, reducing revenue cycle spend and delivering exceptional results. Ensemble partners with hospitals across the United States to make real and lasting improvements that impact the bottom line.

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