Revenue Integrity Analyst II

Intermountain Health • Lake Park, IA

6d • $38 - $60 • Onsite

About The Position

This position is responsible for billing, follow-up, and resolving issues that delay or prevent payment of the patient's account within Intermountain's policies and procedures. The scope of this role involves analyzing data, developing reports, reviewing trends, and recommending enhancements as defined by the RI leadership team. The analyst will proactively seek out positive or negative trends in charge/coding capture and editing processes to facilitate the sharing of best practices and performance improvement opportunity identification. This role also requires understanding and assisting in other areas of the revenue cycle to support the quality and compliance of charges and documentation. The analyst will participate in, research, and follow-up on topics presented at department and system-wide initiatives, including audits and reviews for government, commercial, and third-party payers. Monitoring the status of RI activities using a defined tracking system, ensuring timely responses, and assisting in the determination of appropriate responses and activities in collaboration with various teams are key responsibilities. Additionally, the analyst will assist management with interviews, onboarding, goal monitoring, annual reviews, and metric design. They will coordinate and oversee orientation and training for new and established associates and partners, validate competency, and perform retraining activities. Staying current in specific areas of focus, providing education and guidance to leadership, providers, and clinical associates regarding updates to charging/coding/NCCI regulations, and facilitating corrective action planning are crucial. Ensuring timely accuracy of revenue capture for specific service lines, validating documentation supports charges, and ensuring alignment with procedure and payer guidelines are essential. The analyst will act as a subject matter resource, escalate to leadership as needed, and support sites with Epic and other system upgrades. Promoting the mission, vision, and values of SCL Health and abiding by service behavior standards are also required. Performs other duties as assigned.

Requirements

• Associates Degree in healthcare related field or two (2) years of prior experience leading others or leading project or programs.
• Certified Revenue Cycle Representative (CRCR) Certification completed within 3 months of hire.
• Current certification as a coder through AAPC or American Health Information Management Association (AHIMA), or Healthcare Finance Management Association (HFMA).
• Three (3) years of direct related experience in revenue cycle operations in an acute and medical office.
• Regular attendance to perform work on site during regularly scheduled business hours or scheduled shifts is required.
• Strong oral and written communication skills with the ability to communicate effectively with diverse audiences.
• Take personal responsibility for personal growth including acquiring new skills, knowledge, and information.
• Demonstrate attention to detail and accuracy in work product.
• Strong problem solving and analytical skills.
• Ability to work independently and as part of a team.
• Basic mathematics skills.
• Intermediate skills in Word and Excel
• Experience collaborating communicating with site staff and leadership and system office personnel
• Interact with others by effectively communicating, both orally and in writing.
• Operate computers and other office equipment requiring the ability to move fingers and hands.
• See and read computer monitors and documents.
• Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
• May require lifting and transporting objects and office supplies, bending, kneeling and reaching.

Nice To Haves

• Bachelors Degree is preferred
• Proficiency in EPIC is preferred
• Prior educator, preceptor, trainer experience is preferred

Responsibilities

• Analyze data, develop reports, review trends, and recommend enhancements as defined by the RI leadership team.
• Proactively seeks out positive or negative trends in charge/coding capture and editing processes to facilitate the sharing of best practice and performance improvement opportunity identification.
• Understands and assists in other areas of the revenue cycle to support the quality and compliance of charges and documentation.
• Participates, researches and follows-up on topics presented at department and system-wide initiatives. These may include audits and reviews for government, commercial and third party payers.
• Monitors status of RI activities using a defined tracking system, ensuring timely responses.
• Assists in the determination of appropriate responses and activities in collaboration with others involved including the care site teams, external business partners/vendors, compliance, legal counsel, health information management, and designated areas in the response process.
• Assists manager with interviews, onboarding, monitoring and measuring goals, annual reviews and metric design activities.
• Coordinates and oversees orientation and training for new and established associates and associated partners in designated areas, validates competency and performs retraining activities.
• Oversees productivity, vacation coverage and work assignments.
• Stays current in specific areas of focus.
• Provides education and guidance to service line leadership, providers, and front line clinical associates regarding updates to charging/coding/NCCI regulations and/or errors, and regarding audits and appeals, to facilitate corrective action planning for improved processes.
• Complies with all CMS, Federal and State regulations, and payor guidelines, and ensures consistent and compliant application with charge/coding capture, charge editing, and audit and reimbursement practices.
• Researches and collaborates on regulation updates to ensure all necessary changes are incorporated into daily workflows.
• Ensures timely accuracy of revenue capture for a specific service line(s), including validation that documentation supports charges submitted, all charges/coding are aligned with procedure performed, and charges/coding are consistent with Federal, State, and payer guidelines.
• Acts as a subject matter resource to team and escalates to leadership as needed.
• Supports SCL and future acute care sites with Epic, downstream system, upgrades and new functionality.
• Promotes mission, vision, and values of SCL Health, and abides by service behavior standards.
• Performs other duties as assigned.

Benefits

• Comprehensive benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree