Revenue Integrity Analyst

Fred Hutchinson Cancer Center•Seattle, WA

12d

About The Position

Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, Fred Hutch is the only National Cancer Institute-designated cancer center in Washington. With a track record of global leadership in bone marrow transplantation, HIV/AIDS prevention, immunotherapy and COVID-19 vaccines, Fred Hutch has earned a reputation as one of the world’s leading cancer, infectious disease and biomedical research centers. Fred Hutch operates eight clinical care sites that provide medical oncology, infusion, radiation, proton therapy and related services, and network affiliations with hospitals in five states. Together, our fully integrated research and clinical care teams seek to discover new cures to the world’s deadliest diseases and make life beyond cancer a reality. At Fred Hutch we value collaboration, compassion, determination, excellence, innovation, integrity and respect. Our mission is directly tied to the humanity, dignity and inherent value of each employee, patient, community member and supporter. Our commitment to learning across our differences and similarities make us stronger. We seek employees who bring different and innovative ways of seeing the world and solving problems. The Revenue Integrity Analyst is responsible for maintaining, coordinating, and implementing Charge Description Master (“CDM”) initiatives and processes. Ensuring the overall integrity of the CDM with a focus on accuracy, revenue cycle integrity, and compliance with third-party payor requirements. This scope includes responsibility for reviewing, analyzing, and trending information being reported to identify the root-cause of issues and facilitate operational changes to improve net revenue and reductions in denials. This position is full-time, hourly

Requirements

Highschool diploma or equivalent
Minimum of two years CDM, health-care finance, or Revenue Cycle experience
Working knowledge of CPT, ICD10, HCPC codes
Strong analytical and statistical skills
Ability to interpret complex data
Proficient in the use of MS Office Suite
Ability to apply critical thinking and analytic skills to troubleshoot and problem solve
Ability to work independently and as part of a team as the situation requires
Knowledge of CMS and Commercial policies and requirements
Knowledge of Ambulatory Payment Classifications
Ability to communicate verbally in person, on the phone and in writing in a clear, concise and professional manner

Nice To Haves

RHIA, RHIT, CCS, CPC, COC
Epic HB experience strongly preferred

Responsibilities

Deliver, monitor and maintain a consistent and accurate CDM in compliance with both state, internal and federal regulatory agencies
Updating CDM (charge description master—CPT codes, standard/research prices, etc.) to ensure optimal facility fees and maximize collections
Reviews changes in pricing, CPT codes, HCPCS codes, and revenue codes for accuracy and compliance with all applicable charging and billing guidelines
Provides coding and pricing estimates requested by internal and or external customers
Maintains Fred Hutch’s coding and pricing documents for customer service, patient navigator, pricing transparency and PFS
Monitor’s and resolves interfaced revenue system charges in EPIC WQ’s
Performs charge reconciliation process to ensure that charges are captured and assist with charge capture entry
Provide communication and education to clinical departments regarding annual and quarterly CPT/HCPCS changes and additions
Conducts special projects and special studies to facilitate revenue management as required for system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, etc.
Reviews, monitors, and facilitates implementation of billing and coding changes affecting charge capture processes in accordance with payer requirements.
Monitors CMS and commercial payor policies.
Prepares and implements action plans with follow-up to departments regarding policy changes
Management of automation build to ensure Q/A post implementation or EPIC updates
Development of library reports in slicers, bench report, dashboard and/or external analytics system
Supporting business continuity preparedness, downtime, and recovery by developing reconciliation reports
Assist with Revenue Cycle Business Planning for impact analysis to mid -back end revenue cycle processes
Supporting data entry by hand keying charges into Epic for specific systems and departments
Coordinating and researching technical solutions to optimize charge capture including referencing technical documentation and resources
Reconciling charges by running Epic workbench or Slicerdicer reports to measure accuracy of charges posted from peer system
Referencing and utilizing reports in Finthrive CDM product to implement best practices and ensure integrity of charge master data.
Other duties as assigned