Revenue Integrity Analyst

UnityPoint Health • Des Moines, IA

65d

About The Position

The Revenue Cycle Integrity Analyst is a key member of the Revenue Cycle Team reporting directly to the Director of Ambulatory Revenue Cycle Integrity. This position is responsible for identifying trends, collaboratively working with leadership to produce in-depth reporting that will help improve the revenue cycle performance within the Ambulatory Clinics of UnityPoint Health (this includes clinics operated by UnityPoint Clinic and UnityPoint Health Hospitals). This Analyst will be responsible for creating dashboards, managing and monitoring all aspects of the clinic related revenue stream. This role will have ongoing interaction with clinic leadership, clinic revenue cycle staff, coding staff, billing staff, and IT teams. This individual will focus on implementing and supporting continuous improvement in key revenue cycle functions including Registration, Coding, and Billing. The Analyst will maintain a good working relationship with all clinics to ensure clear communication and a collaborative approach to implementing best practice processes.

Requirements

• High school diploma/GED required.
• Bachelor’s degree in Healthcare Administration, Business, Mathematics or Computer Science preferred.
• 4 years of progressive experience in revenue cycle/medical billing.
• Strong skills including professionalism, interpersonal skills, ability to communicate effectively through written and verbal methods, process improvement skills.
• Fluent with Epic and Microsoft office programs.
• Ability to manipulate large amounts of data.
• Demonstrated decision making as it relates to processing, reconciling, and ensuring the accuracy of revenue and charge activity.
• Knowledge of entire revenue cycle process.
• Knowledge of medical terminology and coding.

Responsibilities

• Analyzes data to identify opportunities for process improvement.
• Develop and produce reporting that will create accountability and drive change.
• Develops and complete critical Revenue Cycle projects by collaborating with key stakeholders across UnityPoint Health.
• Collects, monitors and analyzes data, and provides recommendations to clinic leadership to drive better performance throughout the revenue cycle.
• Responsible for decision making to improve and impact charge issues, complex claims processing workflows and regulations.
• Provides expert consultation to leadership as the subject matter expert for revenue cycle data.
• Interprets existing revenue cycle policies and operating practices to make recommendations for improvements.
• Responsible for maintaining in-depth understanding of the entire revenue cycle.
• Responsible for troubleshooting registration, coding, and correct coding initiative (CCI) edits.
• Research and resolve charge review, claim edit, and denial in assigned work ques (WQ).
• Liaison for the billing office team members, answering questions and troubleshooting accounts as needed.
• Maintain understanding of new rules and regulations related to billing.
• Research new service line rules and regulations.
• Responsible for self-monitoring of WQs and identifying potential charging issues.
• Assists with collection, monitoring and analyzing data, and gives feedback to management for recommendations to leadership to drive better performance throughout the revenue cycle.
• Identifies different types of data that require tracking to improve revenue cycle performance.
• Develops easy-to-interpret reporting based on collected data and develops operating procedures in collaboration with clinic leadership to ensure continued monitoring.
• Provides guidance and education to Revenue Integrity Specialist related to performance monitoring and revenue integrity functions.
• Work with clinic leadership to prioritize suggested changes.
• Provides training as needed to improve operations.
• Monitor revenue cycle Key Performance Indicators and identify areas of opportunity for improvement and efficiency.
• Drive change through data and collaboration with clinic leadership and staff.
• Work with clinic leadership and staff to identify and remediate denials through rules and EMR build.
• Produce reports that track performance and are easy-to-interpret.
• Develop an understanding of complex rules and regulations governing insurance, appeal activities, trends, etc. and make recommendations on system build to accommodate changes in these areas.
• Develop an understanding of the entire revenue cycle and the factors that lead to denials and revenue loss.
• Serves as the subject matter expert for leadership, peers and team members for denials management.

Benefits

• Paid time off.
• Parental leave.
• 401K matching.
• Employee recognition program.
• Dental and health insurance.
• Paid holidays.
• Short and long-term disability.
• Pet insurance.
• Early access to earned wages with Daily Pay.
• Tuition reimbursement.
• Adoption assistance.

What This Job Offers

• Job Type: Full-time
• Education Level: Bachelor's degree