Western Michigan University Homer Stryker MD School of Medicine (WMed) is recruiting for a Revenue Integrity Specialist. In this role, the ideal candidate will work to improve compliant and accurate billing and charge capture at the point of service. Implement and promote consistent revenue integrity practices in regards to compliance in coding, billing, and proper documentation. Optimize reimbursement working in partnership with departments to further develop the revenue stream and documentation processes.
Analyzes and assists with correction of billing and coding errors, and provide real time notification to unusual variances. Advises regarding proper revenue cycle processes and workflows. Assists or advises departments regarding resolution of errors that prevent timely, accurate, and compliant claims submittal. Help departments to maximize revenue with CPT (Current Procedural Technology) codes for new technologies and services.
Reviews revenue performance works closely with the Assistant Director of Patient Billing reviewing charge line item level, monitoring charge capture volume in units, RUVs, and dollars posted. Identifies significant declines in revenue, analyzes patterns, performs sample audits, identifies revenue risk, and notifies appropriate departments and administrators of issues. Performs close revenue monitoring following events that could impact the physician revenue cycle including implementation of Electronic Medical Record software modules or the addition of outpatient clinics and specialties.
Assist with establishing Revenue Cycle and Billing reporting. Reviews charge capture processes to identify revenue opportunities or risk. Performs other Revenue Integrity duties as assigned.
Education & Training
Identifies need for education and works closely with departments as how to bill for new services, Global Period billing and appropriate use of modifiers. Education to Providers and frontline staff regarding front end processes that affect the revenue cycle downstream. Conducts educational sessions for Billers, Coordinators, and other staff. May serve as a resource to Departments on how to bill for new services, and other billing matters. Performs other Education & Training duties as assigned.
EPIC Charge Review Work Queue Monitoring and Resolution
Provides guidance and/or assistance in the correction and prevention of charges that prevent compliant, timely, and accurate claims. During course of resolution of all edits, identifies improper billing and coding including duplication of charges, incorrect procedure billing such as under coding, up coding, wrong CPT (Current Procedural Terminology) code, or wrong number of units. Recommends changes to CPT procedures or diagnosis codes per coding guidelines.
About Western Michigan University Homer Stryker M.D. School of Medicine
As a newer US medical school, WMed is an exciting environment to pursue an academic career. The medical school is a collaboration of Western Michigan University and Kalamazoo's two teaching hospitals, Borgess Health and Bronson Healthcare. Planning for the new medical school began in 2008 and achieved full accreditation of the MD program by the Liaison Committee on Medical Education in 2018, and candidate status for institutional accreditation by the Higher Learning Commission in 2016. The school welcomed its inaugural class in August 2014, and is a private 501(c)(3) nonprofit corporation supported by private gifts, clinical revenue, research activity, tuition, and endowment income. The home of the new medical school includes the WMU Homer Stryker M.D. School of Medicine Clinics, a modern 60,000-square foot clinical building on the Oakland Drive Campus, and a 350,000-square foot educational building in downtown Kalamazoo located on the W.E. Upjohn M.D. Campus. The building, donated by MPI Research, underwent a $68 million renovation and expansion project, including a 24,000 state-of-the-art Simulation Center. In 2016, an additional $10 million expansion created two floors supporting clinical and laboratory research, and the medical school acquired the Innovation Center, a 69,000-square foot, purpose-built incubator and co-working space, located on the Parkview Campus.
There are more than 200 residents and fellows in nine residencies and three fellowships accredited by the Accreditation Council for Graduate Medical Education (ACGME). WMed is accredited by the Accreditation Council for Continuing Medical Education (ACCME) for continuing medical education.
Kalamazoo is a wonderful and vibrant city, located midway between Chicago and Detroit. It is a short distance from Lake Michigan, and home to two nationally ranked institutions of higher learning, Western Michigan University and Kalamazoo College. Kalamazoo is known for its community focus and emphasis on access to quality education at all levels. The Kalamazoo Promise is a nationally renowned program in which graduates of Kalamazoo Public Schools receive free tuition to attend public and private colleges in Michigan. At the other end of the educational continuum, the Kalamazoo Ready 4s program ensures that every 4-year-old in Kalamazoo County has the opportunity to attend a high-quality pre-kindergarten program, regardless of ability to pay. Kalamazoo and Michigan provide extensive entertainment and recreational activities, including opportunities to enjoy the outdoors, unique restaurants and shops, and a strong culture supporting the arts.
Western Michigan University Homer Stryker M.D. School of Medicine is an Equal Employment Opportunity /Affirmative Action employer of females, minorities, individuals with disabilities, and protected veterans, and actively strives to increase diversity within its community. We provide a drug- and tobacco-free workplace.
EEO Minorities/Women/Disabled/Protected Veterans.