Remote - Revenue Integrity Analyst

Mosaic Life Care•Saint Joseph, MO

14h•Remote

About The Position

As part of the Revenue Integrity department, the Revenue Integrity Analyst is responsible to identify and correct the processes and systems that lead to lost revenue opportunities and reduced reimbursement for the care provided to patients. As part of ensuring operational integrity of the charge posting processes the position performs and reviews regular audits that supports the maintenance and enhancement of Mosaic Life Care's charge capture, compliance and billing functions. In addition, the position explores potential charge capture workflow enhancements, the application of a consistent charge structure and reviews rate setting, according to industry standards, payer contracts, and denial trends. The position ensures that charges make it to billing by working with the departments and Technical Services to monitor that processes are in place to handle charge interface exceptions that might turn into lost revenue. The role may also be involved in the design and implementation of data extraction and analytics processes across departments and service lines that helps pinpoint potential revenue leakage. The position maximizes charge efficiency through: (1) Monitoring revenue cycle processes and staff functions; (2) Supporting Mosaic Life Care's revenue capture and integrity through evaluating the accuracy of charge capture and billing functions and staying apprised of payer and/or regulatory updates; (3) Assisting in the design and implementation of charge capture/billing workflow improvements. Resolves Epic WQs pertaining to CCI and MUE Edits, Denials, Missing Cost Center, Missing Charges, Charge Review WQs, Physician Missing Charges Reports and Revenue Guardian edits. Performs RAC audits and appeals. Assists with CDM updates; annual CPT/HCPC code updates and training. Performs other duties assigned.

Requirements

Candidates residing in Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia will be considered for remote employment.

Responsibilities

Identify and correct processes and systems that lead to lost revenue opportunities and reduced reimbursement.
Perform and review regular audits to support charge capture, compliance, and billing functions.
Explore potential charge capture workflow enhancements, consistent charge structure application, and rate setting reviews.
Monitor processes for charge interface exceptions to prevent lost revenue.
Involved in the design and implementation of data extraction and analytics processes to pinpoint revenue leakage.
Monitor revenue cycle processes and staff functions.
Evaluate accuracy of charge capture and billing functions and stay apprised of payer/regulatory updates.
Assist in the design and implementation of charge capture/billing workflow improvements.
Resolve Epic WQs pertaining to CCI and MUE Edits, Denials, Missing Cost Center, Missing Charges, Charge Review WQs, Physician Missing Charges Reports and Revenue Guardian edits.
Perform RAC audits and appeals.
Assist with CDM updates.
Perform annual CPT/HCPC code updates and training.
Perform other duties assigned.