Analyst, Rev Cycle Compliance - Corporate Revenue Integrity - Full Time

Guthrie Enterprise•Sayre, PA

2d•Onsite

About The Position

Provides research, analysis and recommendations regarding the organization's compliance with regulatory/statutory requirements affecting patient billing and accounting practices.

Requirements

Current knowledge of regulations and statutes regarding patient billing and accounting practices.
Ability to research compliance questions and provide recommendations.
Experience conducting regular bill audits.
Experience coordinating Medicare and other regulatory reviews/audits.
Ability to monitor key compliance measures and develop corrective action plans.
Assistance with research, correction, and processing of claims not passing CCI edits.
Ability to analyze data to identify likely relationships, summarize data, and prepare summary materials.
Experience designing and refining reporting for process improvement.

Responsibilities

Maintains current knowledge of regulations and statutes regarding patient billing and accounting practices.
Researches questions related to the organization's compliance and provides recommendations.
Conducts regular bill audits.
Coordinates Medicare and other regulatory reviews/audits.
Provides recommendations to management based on audit results.
Monitors key compliance measures and develops corrective action plans based on analysis.
Ensures all claims are submitted in accordance with CCI guidelines by assisting Medicare billers with research, correction and processing of any claim not passing CCI edits.
Make recommendations for solutions to prevent recurrence of errors.
Analyzes data to identify likely relationships, summarizes data and prepares summary materials for discussion with clinical and finance teams.
Designs and refines reporting that provides insight for process improvement operations.