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Facility – Revenue Integrity and Payment Consultant
The Rybar Group, Inc.

Location: Fenton, Michigan
Work Setting: Consultant/Vendor
Job Function:
Consultant
Job Type:
Full-Time

Introduction

The revenue integrity and payment consultant is responsible for completing all projects related to facility coding, compliance and reimbursement in the Revenue Integrity and Payment department. This position is responsible for providing clients with the highest quality facility documentation and coding expertise in a cost-effective way. This position has responsibility to ensure the client’s needs are exceeded by providing exceptional client service.

 

 

Job Description

ESSENTIAL DUTIES & RESPONSIBILITIES:

Duties & Responsibilities

  • Continually contribute to the evolution of the service line as the industry needs change.
  • Perform coding and documentation audits to ensure accurate DRG and APC assignment and that all codes are assigned according to current nomenclature and adhere to current regulations and established guidelines, including ICD10 and UHDDS.
  • Identify and capture all coding, documentation, system and process opportunities throughout the engagement and be able to represent these findings in a confident and concise manner both face-to-face and via conference call.
  • Populate audit tools while performing the audit.
  • Utilize system(s), resources and reference tools to efficiently audit, research and document findings.
  • Compose detailed reports of any audit results and respective recommended action plans for the client.
  • Analyze high-level trends to make recommendations for ongoing coding and documentation compliance.
  • Research inquiries from clients and develop clear and concise advice and feedback with supporting documentation and respond quickly.
  • Provide PowerPoint presentations to clients, prospective clients, and associations.
  • Serve as a departmental expert for RGI associates.
  • Other duties may be assigned as necessary.

Performance Standards

  • Maintain regular and consistent attendance at work.
  • Maintain a minimum billability rate of 75%.
  • Maintain membership in AAPC and/or AHIMA and adhere to AAPC/AHIMA Code of Ethics following ethical principles of professional conduct.
  • Adhere to all RGI Policies and Procedures and departmental policies.
  • Achieve the goals as defined in the Goals Module in HRweb. These goals will be determined on a yearly basis, as part of the performance appraisal process.
  • Travel onsite to clients as necessary. Includes day travel and overnight stays. Approximate 15%-25%.

Communication

  • Interact with clients (to include hospitals, clinicians and attorneys) regarding documentation, policies, procedures and regulations, when applicable.
  • Create an ongoing communication plan with the client and foster a relationship based on trust and expertise.
  • Write educational articles for newsletters and publications.
  • Represent The Rybar Group and Revenue Integrity and Payment department at speaking engagements, seminars, conferences, etc. as needed.

Personal Development

  • Maintain active membership in appropriate association(s) to promote professional interaction with peers to include activity on relevant committee(s).
  • Regularly research, develop skills and increase knowledge relating to the departmental service areas.
  • Willingness to embrace challenges and perform special audit assignments and research as required and assigned.

Collaboration & Team

  • Facilitate problem solving and collaboration within the organization and your team through regular status updates, meetings and reports.
  • Provide input to management for value-added services to our clients based on industry trends.
  • Foster unity through sharing knowledge, mentoring each other, and holding teammates accountable for team performance.

Required Qualifications

QUALIFICATIONS:

Education, Certification & Training

  • Associates or bachelor’s degree in related area, or equivalent experience
  • AHIMA coding credential required (RHIA, RHIT or CCS)

Experience

  • 4+ years of facility auditing and/or coding experience
  • 8+ years of directly related experience preferred (i.e. CDI, coding, reimbursement, CDM, and/or charge capture)

Preferred Skills

  • Prior work related to a client base of attorneys, hospitals/health systems, physician practices, medical groups and/or accounting firms
  • Work related to operational process improvement within a clinical setting
  • Work related to quality measures, EHR incentives and other regulatory requirements related to facility reimbursement
  • Experience with the development of revenue integrity programs, such as clinical documentation improvement, for inpatient or outpatient settings

Skills

  • Demonstrate extensive knowledge and understanding of relevant facility-based services and operations, including expertise in the areas of clinical documentation improvement, coding, charging, billing, and reimbursement processes
  • Expert level experience in ICD-10-CM & PCS, CPT® (in a facility setting) and HCPCS coding in all settings (inpatient, outpatient, ancillary, etc.)
  • Strong analytical capabilities with the ability to analyze large sets of data and provide expert feedback to clients based on the data analysis
  • Provide clients with the highest quality work and develop a reputation as the go-to expert in the industry
  • Provide complete, accurate, consistent and timely reports within budget and project deadlines
  • Work to not only meet the client’s needs but a relentless focus on exceeding with value-added services based on improvement opportunities
  • Ability to prioritize workload, work in a fast-paced environment and make sound decisions
  • Proven accountability for multiple projects while still meeting project budgets and revenue goals
  • Ability to communicate effectively with senior executives, business partners, investors, attorneys, accountants, clinicians and revenue cycle clients
  • Excellent written and verbal communication skills, as well as presentation skills
  • Proven track record of exemplary client satisfaction
  • Ability to process industry trends and updates to develop value-added client services

Preferred Qualifications

  • Additional specialty-specific AAPC, AHIMA or HCCA coding credentials preferred

Education Qualifications

  • Associates or bachelor’s degree in related area, or equivalent experience
  • AHIMA coding credential required (RHIA, RHIT or CCS)
  • Additional specialty-specific AAPC, AHIMA or HCCA coding credentials preferred

Compensation/Benefits

RGI has a full benefit package including profit sharing and health benefits which will be provided upon request.

Instructions for Resume Submission

Please send resume to Brandy Hodge, Director of Human Resources to hr@therybargroup.com

Posted: September 19, 2019 at 3:03 PM
Post ID: 42979

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