Revenue Integrity Analyst

Children's National Hospital

6d•$65,125 - $108,555•Onsite

About The Position

The incumbent for this position is responsible for coordinating the charge master system and function, which is a listing of hospital services and procedures and the charges associated with those procedures. This position will utilize charge master management software and other resources to maintain a complete, accurate and standardized charge master. This position will provide charge master expertise, support, education, guidance and recommendations to clinical and administrative departments in order to optimize net revenue.

Requirements

Associate's Degree (Required)
3 - 5 years of experience in charge capture, coding or charge description master in a hospital environment (Required)

Nice To Haves

Bachelor's Degree Healthcare related field or equivalent work experience (Preferred)

Responsibilities

Provide education and in-service training to departments.
Provide assistance and analysis to all levels of clinical management in support of suggested, requested and/or mandated changes to the CDM.
Process CDM requests to ensure that all additions, changes and deletions are consistent with proper charging, billing, coding and pricing practices in a timely manner.
Conduct annual review of the charge master and quarterly updates as appropriate to enhance revenue for the hospital departments.
Analyze data within the CDM and assign accurate CPT/HCPCS and revenue codes to the Charge Master to insure compliance with regulatory agencies.
Distribute coding and billing regulatory requirements and/or announcements to all applicable departments.
Responsible to make CDM related decisions that require significant analysis and investigation.
Develop and maintain policies and procedures for the CDM, Pricing Policies and charge capture processes.
Perform all maintenance to the Charge Description and Service Master and the Room and Bed Master Files.
Create and maintain all hospital transaction codes and revenue department codes.
Monitor and report all revenue department's charge volumes and posting lag days.
Research and resolve all charge and service master related code errors that affect the recycle and reject reports.
Assist in performing comprehensive reviews with clinical departments to ensure completeness and accuracy of charge description master.
Take initiative to identify system and/or operational problems and participate in the development of solutions to improve billing functions.
Serve as expert resource for code and processing questions, train and educate coders.
Maintain relationships with, and serve as liaison to department administration, physicians, clinic administration, information services, billing offices, financial offices and other departments.
Participate in team meetings/activities and support the philosophy and goals of the team and department.
Adhere to internal controls and reporting structure.
Remain current with updated coding and billing regulations through yearly continuing education; read all announcements and relevant communications that relate to job duties.
Lead special projects/assignments.
Speak up when team members appear to exhibit unsafe behavior or performance.
Continuously validate and verify information needed for decision making or documentation.
Stop in the face of uncertainty and takes time to resolve the situation.
Demonstrate accurate, clear and timely verbal and written communication.
Actively promote safety for patients, families, visitors and co-workers.
Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance.