Revenue Integrity Analyst

Saint Luke's Physician Group•Kansas City, MO

1d•Remote

About The Position

The Revenue Integrity Analyst supports the Revenue Integrity Department and departments across the Revenue Cycle. The position improves charge-capture accuracy through workflow assessments, coding reviews, process improvement, collaboration, and reporting. It works with leadership to develop, manage, and implement process enhancements and organizational initiatives, and monitors and analyzes coding performance at the section and business-unit levels. The Analyst serves as a liaison among revenue cycle operations, IT, and finance on charge capture, documentation, and reconciliation, and must understand the physician revenue cycle and departmental charging processes, including CDM charge linkages. The role also analyzes denial trends and communicates them to providers and operational leaders. The position supports education, documentation principles, clean claims, and denial prevention. It provides education to physicians, APPs, and other billable providers on documentation and coding at the highest level of service rendered, while supporting charge accuracy, denial prevention, reconciliation, revenue maximization, and compliance throughout the revenue cycle, operations, and IT. This is a telecommuting position requiring residence in the Kansas City metro area because travel to area clinics may be needed. The role is exempt, requires availability Monday through Friday during business hours, and offers career-ladder advancement opportunities and a bonus program.

Requirements

Three to five years of applicable experience.
Three years of experience as a coder.
Two years of experience in auditing or chart review.
Advanced knowledge of coding, auditing, and documentation guidelines.
CPC or CCS certification and CPMA or CEMA certification are required.
Availability Monday through Friday during business hours.
Must live in the Kansas City metro area due to potential travel to area clinics.

Responsibilities

Conduct regularly scheduled chart audits and provide education to physicians, APPs, and other billable providers based on audit results and identified educational needs.
Conduct audits for focused requests, including internal reviews, program and payment integrity reviews, and payor programs; help facilitate requests from receipt through completion.
Research and communicate regulatory requirements and payor policies affecting charging and reimbursement in assigned areas.
Use data such as revenue, RVUs, denials, CPTs by specialty, and documentation lag days to identify education and improvement opportunities, accuracy issues, outliers, and missed revenue.
Train departments on charge reconciliation and monitor whether reconciliation is occurring 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 roll out new codes accurately and on time.
Analyze and ensure that codes are dropping correctly for services not coded by HIM.
Support operational leaders on initiatives related to charge capture, documentation, and reimbursement.
Collaborate with other departments, including MILs, CDI, CDS, HIM, and Charge Management, and with vendors on shared coding-alignment responsibilities and impacts.
Analyze and communicate denial trends to providers and operational leaders.
Assist leadership with developing, managing, and implementing process enhancements and organizational initiatives to improve charge-capture accuracy.