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Full-time
high school
Posted 44d ago
Apply by Jun 24
~40 hrs/week
Responsibilities
The Revenue Integrity Coordinator identifies and corrects causes of denied, rejected, or underpaid claims to protect hospital revenue. They lead the team in retrieving clinical data for authorizations and provide reporting to facilitate performance improvement across the system.
Requirements
Requires a high school diploma or equivalent, with some college preferred and at least five years of experience in registration, insurance verification, or utilization review. Candidates must possess strong computer skills and a working knowledge of medical terminology.
Full job description
Overview
The Revenue Integrity Coordinator (RIC) is responsible for the identification, implementing and monitoring results for all revenue integrity related activities in accordance with department policy. This includes working with team members to identify causes of denied, rejected, or underpaid claims. The RIC will take action in correction errors and by making appropriate referrals that will result in the protection of potentially lost revenue. The RIC will track and report causes of denied, rejected, or underpaid claims and work front end/concurrent/and retrospective case for authorizations. The RIC will lead the team to retrieve, enter, and/or disseminate date to receive authorization on concurrent and retrospective cases. The work of the RIC will include providing information, through team reporting, to the appropriate individuals to facilitate performance improvement throughout the DCH System. The RIC role will provide oversight of the team focus on preventing and reversing denials.
Responsibilities
Develops detailed knowledge of and drives the focus and goals of Utilization Review (UR)
Retrieves and disseminates clinical data to third-party payers for authorization/certification of hospital level of care for front end/concurrent and retrospective certifications
Provides orientation, direction, and ongoing mentoring/coaching of the Care Coordination Clerk (MOONs; IMMs; Condition Code 44’s, Kepro Requests for Medicare appeals, entering moms & babes on JIVA & MIDAS, etc)
Refers adverse outcomes from third-party payers to appropriate member of the UR team
Identifies opportunities for improvement related to denial management and report outcomes to the URM at least monthly
Works with the DCH financial counselors and registration to identify correct/accurate payer source
Documents data in third-payer payer systems allowable within the revenue integrity skillset
Documents certification data in Care Management and Business Office systems
Maintains accuracy of inpatient and outpatient working spreadsheet to include posting of payment, payment date, payor, and action performed
Works within established processes of UR to identify denied/rejected/underpaid claims
Performs interventions, appeals, and appropriate referrals to protect and collect potentially lost revenue by following up on inpatient and outpatient interventions and appeals to include calling insurance companies, physician’s offices, patients, and related DCH departments
Maintains spreadsheet of criteria utilized by payers to deny claims or oversees this document
Provides oversight for authorizations and denials and forwards to Medical Records
Assists UR Manager in developing strategies for overturning appeals and reversing denied claims
Applies critical thinking skills and knowledge to each claim to prioritize and perform interventions to maximize revenue protection within timely filing
Ensures that communications are maintained regarding revenue integrity with all involved departments
Supports the team through follow-up on inpatient and outpatient appeals and interventions
Utilizes Compliance 360, MIDAS, and eFR for reports and information related to denials
Attends departmental meetings and assists the URM in educating the UR team on denial prevention
Participates in annual departmental project and assists in leading the team in UR denial prevention
Assists URM to arrange team meetings and may be responsible for minutes as necessary/requested
Maintains performance, patient and employee satisfaction and financial standards
Adheres to DCH Behavioral Standards including creating positive relationships with patients/ families, and colleagues
Provides level of care reports to Medical Records
Provides back-up clerical support as needed
DCH Standards:
Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
Performs compliance requirements as outlined in the Employee Handbook.
Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
Requires use of electronic mail, time and attendance software, learning management software and intranet.
Must adhere to all DCH Health System policies and procedures.
All other duties as assigned.
Qualifications
MINIMUM KNOWLEDGE, SKILLS, EXPERIENCE REQUIRED
Current approved Alabama Board of Nursing RN license or multi-state license required or ability to obtain prior to start.
Current American Heart Association (AHA) or American Red Cross Basic Life Support (BLS) Provider training required.
BSN preferred, minimum Associates required
Must be able to read, write legibly, speak, and comprehend English.
Required within 6 months of start date: American Heart Association or American Red Cross accepted
Cardiac/Critical Care:
ACLS
Emergency Department-both campuses:
ACLS
Pediatric Advanced Life Support (PALS)
Emergency Department – Regional Campus only:
Trauma Nursing Core Course (TNCC)
Perioperative:
ACLS
PACU –PALS; ACLS
Women’s/Children:
NICU –Neonatal Resuscitation (NRP)
Labor & Delivery –ACLS, NRP, and Intermediate Fetal Monitoring
Mother Baby Unit – NRP
Pediatrics – PALS
Clinical Support:
Cardiac Monitoring Unit –ACLS
Dialysis:
ACLS
International RNs:
Current approved Alabama Board of Nursing RN license or multi-state license required or ability to obtain prior to start.
Current American Heart Association (AHA) or American Red Cross Basic Life Support (BLS) Provider training required or obtain within 30 days of start date.
BSN preferred, minimum Associates required
Must be able to read, write legibly, speak, and comprehend English.
Working Conditions
WORK CONTEXT
Demonstrate leadership skills
Requires decision making that will affect others
Responsible to achieve outcomes
Must be able to communicate clearly and accurately
Ability to delegate to team members and students
Must be able to receive delegation
Address conflict and stressful situation
Communicate with different personalities and engage in face to face discussion
Dealing with unpleasant or verbally/physically aggressive personalities
Must be able to use electronic mail, telephone and texting
Must be able to work in groups
Must be able to perform structured and unstructured work
Must be able to meet time pressure and time lines
Includes possible exposure to human body fluids, disease, infection, lab chemicals and hazardous materials and/or cleaning solutions
Requires wearing of common protective and safety equipment such as gloves, safety glasses, mask, gowns, etc.
Schedules vary; every other weekend required. Weekends include Saturday & Sunday
PHYSICAL FACTORS
Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.Must be able to tolerate prolonged periods of standing and walking
Must be able to reach reasonable distances in any direction
Must be able to stand, walk, kneel, bend, sit and stoop
Must be able to run in an emergency
Must have the ability to exert maximum muscle force to lift, push, pull and carry objects
Must be able to move fingers in a coordinated manner and must be ablet o feel and perceive temperature, texture, shape and size with fingertips
Must be able to perform the duties with or without reasonable accommodation
Must possess stamina to work prolonged shifts
Hearing and vision must be normal or corrected to within normal range.
Based in Tuscaloosa, AL, DCH Health System has been providing quality and compassionate healthcare to the residents of West Alabama. Comprised of DCH Regional Medical Center, Northport Medical Center and Fayette Medical Center, the DCH Health System provides comprehensive services in:
- Cancer treatment
- Critical Care
- Cardiac Services
- Bloodless medicine
- Home health care
- Sleep medicine
- Occupational medicine
- Sports medicine
- Spine/pain care
- Therapy services
- Women’s services
- and much more
DCH Regional Medical Center has 583 beds and offers a variety of specialty units and advanced services, including cancer, cardiology, robotic and minimally invasive surgery, and the region's most advanced trauma center.
Northport Medical Center is a 204-bed community hospital that offers a full range of inpatient and outpatient services. The facility also operates the DCH (inpatient) Rehabilitation Pavilion and North Harbor Pavilion for mental health.
Fayette Medical Center, through a lease agreement with the DCH Health System, is a 61-bed rural hospital that offers the residents of Fayette County inpatient care, along with sophisticated diagnostic equipment, surgical techniques and specialty clinics. A 122-bed nursing home on site is fully accredited and licensed for intermediate and skilled nursing care.
Our goal is to provide the best health system possible for patients to receive proper care, employees to work efficiently, and physicians to practice medicine for the benefit of everyone.
Offices: 809 University Blvd. E., Tuscaloosa, AL 35401, US · 2700 Hospital Dr., Northport, AL 35476, US · 1653 Temple Ave., Fayette, AL 35555, US
Inpatient health servicesoutpatient health servicespain clinicinpatient rehabilitationhome health/DMEsleep medicineoccupational medicineimaging (MRICT and PET)cancer center
Based on 401 listings with disclosed salaries, most healthcare jobs in Alabama pay between $60k–$150k per year. Individual offers vary with seniority, company size, and specialization.
How many Healthcare jobs are open in Alabama right now?
There are currently 6,743 open healthcare positions in Alabama listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in Alabama?
Companies currently hiring include Huntsville Hospital, Community Health Systems, Brookwood Baptist Health, CVS Health, UAB Medicine, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in Alabama?
Yes — 266 of the 6743 open healthcare positions offer remote or hybrid work (147 remote, 119 hybrid).
How do I apply for Healthcare jobs in Alabama?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.