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Revenue Integrity Specialist
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Ryze Renal Care
Tampa, FL (In Person)
$67,100 Salary, Full-Time
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Job Description
Revenue Integrity Specialist Ryze Renal Care Tampa, FL Job Details Full-time $51,200.09 - $83,000.00 a year 21 hours ago Benefits Health insurance Dental insurance Paid time off Employee discount Qualifications Contract management Collaboration Attention to detail Contracts Medical terminology Full Job Description Job Overview We are seeking a proactive and detail-oriented Denials, Appeals & Insurance Contracting Specialist to join our dynamic healthcare team. In this vital role, you will be responsible for managing the appeals process for denied insurance claims, negotiating and contracting with insurance providers, and ensuring accurate medical coding to facilitate timely reimbursements. Your expertise will help improve revenue cycle efficiency, ensure compliance with insurance policies, and support the overall financial health of our organization. This position offers an exciting opportunity to make a meaningful impact by navigating complex insurance procedures and advocating for patient care. Duties Review and analyze denied claims to identify reasons for denials, including issues related to DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology) coding, ICD-9 and ICD-10 diagnosis codes, and medical billing errors. Prepare and submit appeals with comprehensive documentation to insurance companies, following established protocols and timelines. Collaborate with medical staff to verify accuracy of medical records, medical terminology, and documentation supporting claims. Negotiate insurance contracts and agreements to optimize reimbursement rates while ensuring compliance with industry standards. Maintain detailed records of all denial resolutions, appeals statuses, and contract negotiations within electronic health record (EHR) systems and other medical record management tools. Stay current on changes in ICD coding standards, DRG updates, and insurance policies affecting billing processes. Assist in training staff on proper medical coding practices, ICD coding updates, and documentation requirements to reduce future denials. Qualifications Proven experience in medical billing, coding (including ICD-9/10 and CPT), or revenue cycle management within a healthcare setting. Strong understanding of DRG classifications, ICD coding systems, and medical terminology. Familiarity with EMR (Electronic Medical Records) systems and EHR (Electronic Health Record) platforms. Excellent analytical skills to review complex medical records and identify issues impacting claim approvals. Ability to communicate effectively with insurance carriers, healthcare providers, and internal teams to resolve billing discrepancies. Knowledge of medical collection processes and best practices for resolving unpaid or denied claims. Prior experience working in a fast-paced environment with attention to detail is highly preferred. Join us in this engaging role where your expertise directly contributes to improved patient care through efficient insurance processing! We value energetic professionals eager to grow their skills while making a positive difference in healthcare administration.