Revenue Integrity Analyst

SSM Health•MO-SSM Health Mission Hill, MO

3d•Onsite

About The Position

Contributes and supports revenue cycle’s mission for achieving operational efficiency, regulatory compliance and proper reimbursement entitlement. Improves revenue with a comprehensive understanding of the revenue cycle. Collaborates with clinical and financial leaders to strengthen charge capture through data analysis, education and training and compliance monitoring by designing, improving and implementing process improvement. Serves as a resource for health ministry clinicians, coworkers, and coding.

Requirements

Demonstrated understanding of revenue cycle processes and data integrity, with strong analytical skills and proficiency in Microsoft Office and Epic.
Extensive experience and in-depth knowledge of revenue cycle operations are required to be successful in this role.
Bachelor’s degree or equivalent combination of education and experience
Three years’ experience within a hospital organization or physician practice environment
Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
Frequent keyboard use/data entry.
Occasional bending, stooping, kneeling, squatting, twisting and gripping.
Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
Rare climbing.

Responsibilities

Leads audit/project evaluations according to RI leadership. Reviews selected medical records documentation to determine accuracy of charges, coding assignments, billing compliance, medical necessity.
Collaborates with shared coding and financial departments to identify opportunities for additional revenue in accordance with payor guidelines.
Meets with departmental leadership to review findings, documentation standards and recommendations for improvement. Actively participates in team development, achieving dashboards and in accomplishing departmental goals and objectives.
Identifies charge trends and compiles information to determine focused reviews of specific departments for leadership. Monitors EPIC Revenue Integrity Dashboard(s) in collaboration with coworkers.
Provides coding, documentation, regulatory and compliance guidance as requested by departments.
Assists and directly provides training and orientation in group settings as well as one-on-one, relative to charge accuracy, coding/billing compliance and DTAR/Charge Reconciliation.
Maintains current knowledge of Charge Description Master (CDM), Charge Preference List (CPL) and Flowsheet Charging to provide support for assigned health ministry to produce a bill/claim.
Remains current with regulation changes and related operational processes by attending coding conferences, workshops and in-house sessions for updated coding information.
Contributes to improvement initiatives as directed by department leaders, focusing on KPIs for performance board as assigned.
Performs other duties as assigned.