Revenue Integrity Analyst
About The Position
Maintains the Chargemaster fee schedule in accordance with established coding practices and governmental regulatory requirements. Conducts quality control audits and review charge capture clinical workflows for missed revenue opportunities. Creates action plans for capturing missed revenue. Identifies edits in patient management/billing software that impacts billing accuracy. Ensures CPT, HCPCS and revenue codes are accurate and compliant will all charging and billing guidelines. Serves as a liaison between Revenue Cycle and clinical operations and information technology regarding revenue, compliance, and clinical workflow build.
Requirements
- Graduation from an accredited school of nursing or equivalent to a Bachelor's Degree in healthcare, finance or a closely related field
- Three (3) years experience in reviewing hospital charge capture, medical records, clinical charts, regulatory and policy compliance, and/or claims auditing.
- Valid state license as a Registered Nurse or certification in one of the following: Certified Professional Coder (CPC), Certified Coding Specialist - Physician based (CCS-P), Certification in Healthcare Revenue Integrity (CHRI), or the ability to obtain certificate within one (1) year of employment.
- 1-2 Years of Outpatient Procedural Coding experience
- 2 Years of maintaining CDM
- Experience using Epic
- Experience in Revenue Cycle Management
- Experience in Revenue Integrity
- Knowledge of CPT, HCPCS and Revenue Codes
Responsibilities
- Maintains the Chargemaster fee schedule in accordance with established coding practices and governmental regulatory requirements.
- Conducts quality control audits and review charge capture clinical workflows for missed revenue opportunities.
- Creates action plans for capturing missed revenue.
- Identifies edits in patient management/billing software that impacts billing accuracy.
- Ensures CPT, HCPCS and revenue codes are accurate and compliant will all charging and billing guidelines.
- Serves as a liaison between Revenue Cycle and clinical operations and information technology regarding revenue, compliance, and clinical workflow build.
Benefits
- Employer-paid pension plan (Nevada PERS)
- Competitive salary & benefits package
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
