Revenue Integrity Analyst

Texas Children's Hospital • Bellaire, TX

76d

About The Position

We're looking for a Revenue Integrity Analyst, someone who's ready to grow with our company. In this position you will lead, manage, and/or participate in all Revenue Integrity related projects as assigned by the Director. This incumbent is also responsible for leading and/or supervising initiatives to improve or optimize efficiency while serving both internal and external customers.

Requirements

• Required H.S. Diploma or GED HSD must be accompanied by a certification or bachelor's degree
• Required Certifications (must hold one of the following): CHRI, CRCR, CHFP, CSAF, CPC, RHIA, RHIT, CCS, CCS-P, COC
• Required 4 years Revenue Cycle experience, including but not limited to Revenue Integrity, Billing, Coding, Denials, Follow-Up, Patient Accounts, and/or Refunds experience.

Responsibilities

• Edit and exception resolution. Resolves or coordinates the resolution of charge session edits including DNB, revenue guardian edits, denials, and audits on a timely basis.
• Apply coding, payer and charge capture conventions to compliantly resolve edits.
• Identifies opportunities for capturing additional revenue in accordance with payer guidelines.
• Keeps edits and exceptions within targets as assigned by leadership.
• Coordinates efforts for resolution with all Revenue Cycle Departments as appropriate.
• Communicates with clinical departments, when needed, to assist in edit resolution.
• Evaluates edits to determine potential opportunities for automated resolution.
• Maintains high productivity and quality with minimal supervision over assigned work queues.
• Develops measures to track, trend, and monitor charge sessions and account resolutions, including audits and denials.
• Provides consistent and clear feedback to the Revenue Integrity Team, Revenue Cycle Counterparts, and Hospital Operations and Providers.
• Track and trend defense audits.
• Identify and monitor departments with charge capture and denial issues and develop processes for improvement.
• Serve as the contact and advocate to assigned Service Line leadership for all revenue cycle processes and workflows.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees