UW Medicine's mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow's physicians, scientists and other health professionals. UW Medicine owns or operates Harborview Medical Center, Northwest Hospital & Medical Center, Valley Medical Center, UW Medical Center, a network of UW Medicine Neighborhood Clinics that provide primary care, UW Physicians, UW School of Medicine, Airlift Northwest, and other owned, operated or affiliated entities as appropriate. In addition, UW Medicine shares in the ownership and governance of Children's University Medical Group and Seattle Cancer Care Alliance a partnership among UW Medicine, Fred Hutchinson Cancer Research, and Seattle Children's. Our staff not only enjoys outstanding benefits and professional growth opportunities, but also an environment noted for diversity, community involvement, intellectual excitement, artistic pursuits, and natural beauty.
UW Medicine has an outstanding opportunity for a REVENUE INTEGRITY SPECIALIST. Under the general direction of the Director, Revenue Integrity, the Revenue Integrity Specialist, has primary responsibility for the on-going accuracy and integrity of the Revenue cycle. Including but not limited to knowledge and application of applicable laws and regulations, as well as working within UW Medicine to ensure process standardization and quality controls across assigned books of business.
The Revenue Integrity Specialist must have skills and knowledge that span the UW Medicine Revenue Cycle from initial business process analysis and report data gathering, error resolution, denial/write-off reduction, to process analysis and improvement. This role is responsible for working with a diverse group of people from All UW Medicine entities to identify revenue cycle improvement opportunities. This requires an understanding of Clinic/Department Revenue Cycle Operational processes, and an understanding of Epic applications, data/business intelligence tools (e.g. Clarity) and utilization across the UW Medicine enterprise.
Assume Accountability and Monitor Key Metrics (Annual Charge Utilizaiton, Monthly Revenue, Denials, Late/Missing Charges, administrative write-offs and utilization by book of business
Analyze trends and anomalies for risk to revenue capture realization
Analyze and develop technical guidance on healthcare finance issues and provide education to service areas as needed for accurate charge capture, billing
Analyze financial impact of CPT Code Changes and provide education to stakeholders
Support accurate and timely charge capture and reimbursement through department education, assistance in goal achievement, and appropriate reimbursement maximization through department operations analysis, issues identification and problem solving
Respond to queries and support new program development
Define and document recommendations and process changes related to Process Improvement and revenue initiatives, system weaknesses, errors, software design and build
Create and review test scenarios for system implementations and upgrades
Provide expertise and oversight during end to end user testing by book of business
Monitor and Resolve Work Queue transactions related to assigned book of business
RESPONSIBILITIES Review, Evaluate, and Monitor Charge Capture/Reimbursement Opportunities
Work with all required (intradepartmental & interdepartmental) personnel to identify charge capture / reimbursement issues and to define resolution approach using available mechanisms (Epic BOE / SSRS reports, Charge Capture Audit (CCA) edit analysis, etc.)
Perform analysis and troubleshooting for charge capture / missing charge resolution and denial mitigation
Monitor revenue and usage and Epic / EpicCare charging / billing data to monitor performance
Assist with the documentation of new operational procedures / processes related to charge capture
Identify, Report, and Rectify Barriers to Timely Charge Capture
Identify, report and rectify patterns and trends related to late and untimely charges
Summarize and provide report-outs to applicable functional areas, clinics and departments
Assist with and document the development of new operational procedures / processes related to Charge Chapter
EPIC Workqueue Issue Resolution
Research and analyze charges held up in Epic Charge Review, Charge Router, Account Work Queues and Error Pool edits
Recommend new reports / existing report improvements that ensure leading practice revenue cycle performance monitoring
Provide feedback to applicable UWMC Clinics and Departments regarding issues identified and facilitate discussions to further identify root cause(s) and potential resolution(s)
Provide functional expertise to implement resolution processes and to optimize edits that define the work queues to drive accountability to the appropriate areas
This position provides opportunities to work in a fast-paced, challenging, diverse and rewarding environment. As an employee you will enjoy generous benefits and work/life programs. For detailed information on Benefits for this position, click here.
Bachelor's degree or equivalent applicable experience in HIM/Coding and/or as a Hospital Clinic/Department manager, supervisor or charge lead role
At least five years experience in the healthcare industry
Extensive experience in with hospital billing or reimbursement
Understanding of CMS regulations and ability to interpret healthcare guidelines and regulations
Experience working in HIM/Coding and/or as a Hospital Clinic manager or supervisor
Clinic Operations expertise from working in specialty clinics is desired/beneficial for this role, particularly in specialty/procedural
Founded in 1861, the University of Washington is one of the oldest public institutions in the west coast and one of the preeminent research universities in the world. The University of Washington is a multi-campus university comprised of three different campuses: Seattle, Tacoma, and Bothell. The Seattle campus is made up of sixteen schools and colleges that serve students ranging from an undergra...duate level to a doctoral level. The university is home to world-class libraries, arts, music, drama, and sports, as well as the highest quality medical care in Washington State and a world-class academic medical center. The teaching and research of the University’s many professional schools provide undergraduate and graduate students the education necessary toward achieving an excellence that will serve the state, the region, and the nation. As part of a large and diverse community, the University of Washington serves more students than any other institution in the Northwest.