Revenue Integrity Analyst

Hartford Healthcare•Farmington, CT

17h

About The Position

The Revenue Integrity Analyst – Level 2 serves as an integral part of both revenue optimization and compliance within the organization through leveraging an integrated, Epic based EMR to assist in the identification, reporting and resolution of any issues stemming from or with charge capture processes for both hospital and professional outpatient services. This role typically services many 1 – 3 of the institutes as these areas growing in size, technology requiring additional dedicated support as it relates to all elements of the revenue cycle, ensuring the financial success of these institutes. The role services both the professional and hospital services as it relates to procedural services. Through the use of data, system reports, and analytics, this role will support the charge capture and accuracy efforts. This position will help to optimize revenue cycle processes by validating, evaluating, and trending large amount of data for presentation to all levels of the organization. This position also serves as technical support for Revenue Integrity staff, Revenue Cycle Departments and Clinical areas

Requirements

Bachelor’s Degree or equivalent Healthcare experience of 10 yrs.
Three to four years of progressive on-the-job experience in an acute care hospital
Certified Coder, (CCS, CPC, etc.)
English - Strong written and verbal communication skills
Extensive knowledge of: · ICD‑10-CM diagnostic and CPT/HCPCS procedure codes · Clinical information related to responsibility areas · Microsoft Office Products; Word, Excel
Skills: · Read, write and speak English proficiently. · Strong analytical capabilities. · Excellent organizational skills. · Proficiently read and interpret physician writing.
Strong ability to: · Function independently. · Handle multiple priorities. · Listen and acknowledge ideas and expressions of others attentively. · Converse clearly using appropriate verbal and body language. · Collaborate with others to achieve a common goal through mutual cooperation. · Influence others for positive and productive outcomes. · Utilize coding subject matter expertise to support new specialized coders and other projects. · Work across the Hartford HealthCare System.

Nice To Haves

Associates degree with health management or financial emphasis and/or health services or ten (10) years of healthcare work experience.
Five (5) years in hospital-based health care setting with experience in facility revenue cycle operations

Responsibilities

Evaluates current charging and coding structures and processes in revenue generating departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements. Assesses the accuracy of all charging vehicles, including clinical systems and dictionaries, encounter forms and other charge documents used to capture revenue
Analyzes denial data to identify root causes of preventable denials, develop and implement corrective action plans to address root causes, including collaborating with the clinical areas as well as other departments within revenue cycle. Optimizes revenue cycle processes by validating, evaluating, and trending large amount of data for presentation to all levels of the organization
Performs regular charge audits, identifying any trends, and implementing corrective actions when appropriate. Document findings and corrective actions reporting to the Revenue Integrity Manager.
Provides guidance, communication and education on correct charge capture, documentation, coding and billing processes.
Lead annual, quarterly, CPT®, HCPCS changes for accuracy, compliance with applicable billing guidelines, and optimization of reimbursement
Communicate CDM maintenance activities to clinical departments and information systems staff to implement necessary changes that affect charge identification, capture, reconciliation, and claim processing. Ensure changes within the charge description master (CDM) coincide and are implemented with clinical systems by reviewing flow sheets or charge capture preference lists.
Monitor national, state, and local information to keep current with applicable regulatory and legislative changes and tailor the revenue integrity program accordingly.
Leads and participates in projects and other duties related to revenue cycle initiatives and duties. Includes training new analysts.