Revenue Integrity Analyst

Adventist Health • Roseville, CA

9h

About The Position

Reviews and analyzes revenue optimization and reconciliation processes, and
identifies and resolves issues while working with Revenue Cycle departments to
ensure accurate and compliant revenue capture. Works on problems of moderate to
diverse scope requiring some interpretation of policies and guidelines. Applies
working knowledge of the techniques, principles, theories and concepts to
complete routine and non-routine assignments.

Requirements

• Associate's/Technical Degree or equivalent combination of education/related experience: Required

Nice To Haves

• Bachelor's Degree: Preferred
• Three years' revenue cycle billing/collections/reimbursement experience or managed care contracting experience: Preferred
• Certified Revenue Cycle Representative (CRCR) Certification: Preferred

Responsibilities

• Independently interprets insurance contracts, government regulations and other non-contracted reimbursement methods to implement and maintain a reimbursement system which accurately calculates expected payments and contractual adjustments from all payers at one or more entities
• Establishes and organizes a systematic transparent revenue integrity audit and improves processes with ongoing tracking, metrics and reporting that demonstrates progress.
• Analyzes payment/contractual adjustment/other system variances and performs detailed reimbursement review to decide whether corrective action is required within the reimbursement system, other revenue cycle departments, and/or with the payer
• Collaborates with Revenue Cycle departments on contract, revenue cycle and payer practice issues in order to increase revenue integrity
• Performs other job-related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree