Revenue Integrity Analyst
About The Position
The Revenue Integrity Analyst will perform internal quality assessment claim reviews to ensure compliance with federal, payer and internal Revenue Cycle policies to ensure complete, accurate and consistent resolution of claims being held due to edits assigned to Revenue Integrity for resolution, resulting from charging and/or reimbursement and data integrity. The position works to improve the accuracy, integrity and quality of patient charges and to ensure minimal variation in charging practices. The Revenue Integrity Analyst researches claim data variances, evaluates payer updates and assist in the performance of chart-to-bill audits to produce and maintain timely, accurate and inclusive charge capture coding and billing functions. Works to identify charge issues and recommend solutions. The Revenue Integrity Analyst also coordinates and manages several projects simultaneously, reprioritizing when necessary. Identifies the key types of data extraction necessary to create enhanced reports and enrich the analysis from several systems for the purpose of increasing revenue.
Requirements
- Bachelor’s degree in health administration, business, finance or related field. Three years’ experience in revenue cycle, analytics or reporting required or High school diploma or equivalent plus seven years revenue cycle billing may be substituted for a Bachelor’s degree.
- Healthcare finance and revenue cycle setting required.
- PC skills including Excel and PowerPoint required.
- Excellent communication skills required.
Nice To Haves
- Certified Professional Coder (CPC) preferred.
- Preferred experience with Epic.
- Demonstrated ability to present analytical topics to a clinical audience and/or senior leadership preferred.
Responsibilities
- Perform internal quality assessment claim reviews to ensure compliance with federal, payer and internal Revenue Cycle policies
- Ensure complete, accurate and consistent resolution of claims being held due to edits assigned to Revenue Integrity for resolution, resulting from charging and/or reimbursement and data integrity
- Improve the accuracy, integrity and quality of patient charges and to ensure minimal variation in charging practices
- Research claim data variances
- Evaluate payer updates
- Assist in the performance of chart-to-bill audits to produce and maintain timely, accurate and inclusive charge capture coding and billing functions
- Identify charge issues and recommend solutions
- Coordinate and manage several projects simultaneously, reprioritizing when necessary
- Identifies the key types of data extraction necessary to create enhanced reports and enrich the analysis from several systems for the purpose of increasing revenue
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
5,001-10,000 employees
