Revenue Integrity Analyst

Saint Luke's Physician Group•Kansas City, MO

7d•Remote

About The Position

The Opportunity: This is a tele-commuting position with a requirement to live in the Kansas City metro area due to some travel to area clinics as needed. The Revenue Integrity Analyst is responsible for improving charge capture accuracy through workflow assessments coding reviews process improvement collaboration and reporting. The Revenue Integrity Analyst works collaboratively with leadership to assist in development project management and implementation of process enhancements or corporation initiatives to enhance charge capture accuracy. In addition this role monitors and analyzes coding performance at the section and business unit levels. The Revenue Integrity Analyst serves as the liaison between revenue cycle operations IT and finance as it relates to charge capture documentation and reconciliation and possesses a clear understanding of the physician revenue cycle. The Analyst oversees understands and communicates departmental charging processes including the CDM charge linkages to the CDM and charging processes. The Analyst analyzes and communicates denial trends to providers and operational leaders. This position requires advanced knowledge in coding, auditing, and documentation guidelines. CPC or CCS and CPMA or CEMA is required. This position is a part of the Revenue Integrity Department and provides support to departments within the Revenue Cycle. The primary role of this position is to support education, documentation principals, clean claims, and denial prevention. This position is an exempt position. RIA would need to be available M-F during business hours. This is a telecommuting position, offers career ladder advancement opportunities, and includes a bonus program. 3 years’ experience as a coder and 2 years of experience in auditing/chart reviews. Revenue Integrity Objective: Support Physicians, APPs and other billable providers by providing education on documentation and coding to the highest level of service being rendered. Serves throughout the revenue cycle, operations, and IT as it relates to charge capture, charge accuracy, documentation, denial prevention, and charge reconciliation while maximizing revenue and compliance.

Requirements

3 years’ experience as a coder and 2 years of experience in auditing/chart reviews
CPC or CCS and CPMA or CEMA is required

Responsibilities

Analyze and conduct regularly scheduled chart audits and education for Physicians, APPs and other billable providers by evaluating education needs from audit results as outlined in our policies.
Analyze and conduct audits for focused requests such as internal reviews, program & payment integrity reviews, payor programs. Participate in facilitation of the process from time it is received to completion of request.
Responsible for research and communication on regulatory requirements and payor policies that impact charging and reimbursement for the areas assigned.
Identify education and improvement opportunities for accuracy, outliers and missed revenue by utilizing data such as: revenue, RVUs, denials, CPTs by specialty, lag days in documentation to provide education to operational leaders and Physicians, APPs and other billable providers.
Train departments on charge reconciliation. Monitor to ensure the charge reconciliation is happening in the areas assigned.
Monitor open encounters to ensure the chart is closing within the guidelines of the policies.
Educate Physicians, APPs and other billable providers, practice leaders and revenue cycle on annual coding updates and drive necessary EPIC revisions. Work with leadership to roll out new codes as applicable and timely.
Analyze and ensure codes dropping are correct for all services rendered outside of that coded by HIM.
Support operational leaders on efforts and initiatives related to charge capture, documentation, and reimbursement items.
Collaborate with other departments (MILs, CDI, CDS, HIM, Charge Mgmt) and vendors to research where shared responsibilities for coding alignment or impact is needed.