Salary Range: $26.79 - $40.37 / hour

The pay range above represents the lowest possible rate for the position and the highest possible rate. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. If you are viewing this posting on a job site, please visit our company page and search for the opportunity to view the pay range: https://careers-mycmh.icims.com/jobs

Pay for PRN positions is calculated differently than Full-Time, Regular Part-Time, and Part-Time positions. PRN Rates depend on the position and other factors, including years of experience, or shift commitment according to the department policy. PRN differential is added in certain positions.

The Revenue Integrity Specialist Support (RISS) is responsible for accurate and timely review of third party payer accounts for claims rejection, insurance denials, and claim issues impacting timely filing and denials at CMH. RISS to collaborate closely with clinical, billing and ancillary departments and provides education to reduce denial related issues related to CMH claims and billing.

Required:

• High School Diploma or equivalent (GED) 
• Three (3) years of experience in hospital billing, including federal and state claims submission
• One (1) year of experience with insurance payers and insurance EOBs
• One (1) year of experience with Revenue Cycle, denials management and claims management

Preferred:

•  Must have technical knowledge of coding selection and UB-04 revenue codes
• Knowledge of Medicare, Medicaid OPPS reimbursement and other 3^rd party billing rules/coverage
• Excellent written, organizational and analytical skills
• Strong accuracy, attentiveness to detail and time management skills
• ability to execute strategy and communicate knowledge of business processes to drive success within Revenue Cycle Management 
• Ability to use Excel spreadsheet, Word, Microsoft Office
• Knowledge and experience with MediTech BAR and/or Epic
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When it comes to quality, we're 5 Star!

Community Memorial Health System was established in 2005 when Community Memorial Hospital in Ventura merged with Ojai Valley Community Hospital. It is comprised of these two hospitals along with a network of primary and specialty care health centers serving various communities across west Ventura County. Our health system is a community-owned, not-for-profit organization. As such, we are not backed by a corporate or government entity, nor do we answer to shareholders. We depend on – and answer to – the communities we serve.

Community Memorial Hospital – Ventura has been awarded a prestigious five-star rating by the Centers for Medicare & Medicaid Services (CMS)! This achievement represents thousands of people going the extra mile every day for our patients, and we are the ONLY hospital in Ventura County to earn this distinction!

Community Memorial Healthcare Benefits

To help heal, comfort, and promote health for the communities we serve, Community Memorial Healthcare takes care of our community of employees so our local community can be cared for. That’s why we provide competitive benefits, along with great career choices, training, and leadership development. Our total rewards package provides benefits that support you and your family’s health and wellness in all aspects of life. From our top tier insurance plans to our employee assistance program, take advantage of what CMH has to offer so you and your loved ones can have peace of mind now and for years to come. CMH is here for you and your family every step of the way.

• Competitive Pay
• Shift Differentials
• In-House Registry Rates
• Fidelity 403(b) Retirement Plan
• Paid Time Off
• Medical (EPO/PPO), Dental, & Vision Insurance Coverage
• Voluntary Worksite Benefits
• Employee Assistance Program Available 24/7 (EAP)
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF)
• Recognition programs
• Employee service recognition events
• Home, Retail, Travel & Entertainment Discounts
• National Hospital Week and National Nurses Week celebrations

Community Memorial Healthcare is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation. We strive to promote an environment where exceptional people bring diverse perspectives and find belonging, support and connection to their work in our community.

“We are an AA/EEO/Veterans/Disabled Employer”