Revenue Integrity Analyst (Full-Time) Hybrid

Virtua Health • Mount Laurel, NJ

218d • Hybrid

About The Position

The position is responsible for root cause analytics along with audits to help identify opportunities, issues, and process improvement within the Revenue Cycle. This role supports the revenue cycle workflows, charge capture, workqueue and denial review processes within an Epic based EMR. This position will help optimize Revenue Cycle by evaluating, validating and trending data for presentation to all levels of the organization. Will support the Virtua Hospitals, Physician Groups and Home Health.

Requirements

• 3 to 5 years experience within a large hospital or integrated healthcare delivery system.
• Ability to work collaboratively across disciplines and business lines.
• Exceptional oral/written communication skills and highly customer-focused.
• Excellent interpersonal and presentation skills.
• Able to communicate with many, various customers.
• Ability to prioritize, plan and execute.
• Excellent critical thinking, analytical skills.

Nice To Haves

• EPIC Revenue Integrity certification.
• Hospital Billing certification.
• Physician Billing certification.

Responsibilities

• Perform quantitative and financial analysis along with audits designed to identify opportunities for improvement across the full spectrum of the Revenue Cycle.
• Assist in ensuring that the charge master and fee schedules are in accordance with government compliance policies and procedures, as well as third party payor needs.
• Review, identify, and analyze necessary CPT changes related to quarterly and annual AMA CPT updates and regulatory changes by timelines set.
• Work with revenue producing departments to ensure the ongoing coordinated consistency of the charge master and fee schedules, including accurate descriptions, coding, additions, deletions, pricing, and any other changes.
• Conduct analytical reviews to determine net revenue effect of proposed charge master and fee schedule changes.
• Perform internal billing audits to ensure correcting coding/billing regulatory compliance and charge capture accuracy.
• Develop close working relationships with management and staff in Revenue Integrity, Finance, Information Technology and Revenue and Clinical Operations.
• Monitor and assist with review of revenue cycle workqueues in Epic.
• Assist in strategic pricing process to optimize reimbursement within budget guidelines.
• Participate in ongoing coordination and resolution of revenue issues as they arise.
• Provide guidance and communication and collaborate with Revenue Integrity Team, Clinical Operations and IT.
• Assist with Epic performance reporting, including assisting with Revenue & Usage, Enterprise Charge Reconciliation and Volume Reports.
• Serve as resource to Patient Financial Services staff for reporting problems and denials on individual claims.
• Analyze billing errors and denial data to identify root cause of issues.
• Lead and participate in projects related to Revenue Cycle initiatives.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees