Revenue Integrity Analyst

Adventist Health • Roseville, CA

2d

About The Position

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. Job Summary: Reviews and analyzes revenue optimization and reconciliation processes, and identifies and resolves issues while working with Revenue Cycle departments to ensure accurate and compliant revenue capture. Works on problems of moderate to diverse scope requiring some interpretation of policies and guidelines. Applies working knowledge of the techniques, principles, theories and concepts to complete routine and non-routine assignments.

Requirements

• Associate's/Technical Degree or equivalent combination of education/related experience: Required
• Three years' revenue cycle billing/collections/reimbursement experience or managed care contracting experience: Preferred

Nice To Haves

• Bachelor's Degree: Preferred
• Certified Revenue Cycle Representative (CRCR) Certification: Preferred

Responsibilities

• Independently interprets insurance contracts, government regulations and other non-contracted reimbursement methods to implement and maintain a reimbursement system which accurately calculates expected payments and contractual adjustments from all payers at one or more entities
• Establishes and organizes a systematic transparent revenue integrity audit and improves processes with ongoing tracking, metrics and reporting that demonstrates progress.
• Analyzes payment/contractual adjustment/other system variances and performs detailed reimbursement review to decide whether corrective action is required within the reimbursement system, other revenue cycle departments, and/or with the payer
• Collaborates with Revenue Cycle departments on contract, revenue cycle and payer practice issues in order to increase revenue integrity
• Performs other job-related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees