Revenue Integrity Analyst

Saint Luke's Health System•Kansas City, MO

4d•Remote

About The Position

The Revenue Integrity Analyst works within the Revenue Integrity Department to support departments across the Revenue Cycle. The role improves charge capture accuracy through workflow assessments, coding reviews, process improvement, collaboration, and reporting. Working with leadership, the Analyst helps develop, manage, and implement process enhancements and organizational initiatives. The position monitors and analyzes coding performance at section and business-unit levels and serves as a liaison among revenue cycle operations, IT, and finance on charge capture, documentation, and reconciliation. It requires a clear understanding of the physician revenue cycle and departmental charging processes, including CDM charge linkages. The Analyst supports education, documentation principles, clean claims, and denial prevention. The role provides education to physicians, APPs, and other billable providers on documentation and coding to the highest level of service rendered, while supporting charge accuracy, denial prevention, charge reconciliation, revenue maximization, and compliance across the revenue cycle, operations, and IT. This is an exempt, telecommuting position with weekday availability during business hours and career ladder advancement opportunities.

Requirements

CPC or CCS certification and CPMA or CEMA certification are required.
Three years of experience as a coder.
Two years of experience in auditing or chart reviews.
Advanced knowledge of coding, auditing, and documentation guidelines.
Bachelor's degree.

Responsibilities

Conduct regularly scheduled chart audits and provide education to physicians, APPs, and other billable providers based on audit results and identified education needs.
Conduct audits for focused requests, including internal reviews, program and payment integrity reviews, and payer programs; help facilitate requests from receipt through completion.
Research and communicate regulatory requirements and payer policies affecting charging and reimbursement in assigned areas.
Use revenue, RVU, denial, CPT-by-specialty, and documentation lag-day data to identify education and improvement opportunities related to accuracy, outliers, and missed revenue.
Train departments on charge reconciliation and monitor reconciliation in assigned areas.
Monitor open encounters to ensure charts are closed within policy guidelines.
Educate providers, practice leaders, and revenue cycle staff on annual coding updates and drive necessary EPIC revisions; work with leadership to implement new codes as applicable and timely.
Analyze and ensure codes are dropping correctly for services rendered outside of those coded by HIM.
Support operational leaders' efforts and initiatives related to charge capture, documentation, and reimbursement.
Collaborate with other departments, including MILs, CDI, CDS, HIM, and Charge Management, as well as vendors, on shared coding alignment or impact.