Revenue Integrity Analyst

Description

Responsible for performing daily activities that will provide and maintain revenue integrity. The person in this role will work closely with the Revenue Cycle Manager assisting with the management and improvement of revenue cycle coding, billing and related processes. Position requires constant analysis and review of data assuring appropriate charge related activity and maximization of corresponding payments. This position will report to the Controller.

Principal Duties and Responsibilities:

· Provide daily maintenance of the charge description master (CDM) file within EPIC

· Work with revenue producing departments to ensure the ongoing consistency of the CDM including accurate descriptions, coding, additions, deletions, pricing, RVUs and any other changes

· Partner with department leaders to ensure clear accountability for daily charge capture and revenue monitoring, to include consultation on eliminating late/lost charges

· Support departments in analyzing and resolving issues related to charge capture

· Perform revenue integrity reviews including analysis of reports and working EPIC work queues allowing for the presentation of findings and determination of corrective action

· Responsible for charge reconciliation and analysis of financial data as it relates to regulatory compliant charging and billing guidelines

· Serve as a resource for organizational and operational matters related to revenue integrity issues as well as revenue integrity education and training programs

· Review, develop, implement, evaluate and revise charge guidelines to optimize revenue management

· Assist with audits, reporting and licensing as needed

· Other projects as assigned and needed

Requirements

· Ability to create, analyze, interpret and report on outcomes and variances relating to coding, charge capture and revenue recognition

· Must be able to act independently with only general supervision

· 3 to 5 years of healthcare experience required

· Coding credential or equivalent revenue cycle experience required

· General knowledge of reimbursement regulations a plus

BS/BA degree or equivalent combination of education and experience preferred