About The Position

The Revenue Integrity and Charge Master Analyst is responsible for maintaining the integrity of the charge master while ensuring compliance with billing regulations and best practices. This role involves analyzing charge capture processes, optimizing revenue opportunities, review of insurance contracts, provider insurance enrollment, and collaborating with clinical and administrative teams to enhance overall revenue cycle performance.

Requirements

  • Bachelor's degree required in healthcare administration, finance or related field.
  • Minimum of 3 years successful experience in healthcare revenue operations.
  • In-depth knowledge of healthcare regulations, coding standards (e.g., ICD-10, CPT), and compliance guidelines.
  • Self-starter who is result oriented with a willingness and desire to work with and through others to accomplish organizational goals.
  • Possess excellent knowledge of healthcare revenue cycle operations as well as communication and presentation skills.
  • Strong capabilities to analyze and interpret data
  • Must be detailed orientated and organized.

Responsibilities

  • Oversee the development, maintenance, and accuracy of the charge master to ensure compliance with regulatory standards and alignment with clinical services.
  • Knowledge of Electronic Health Records (EHR) - EPIC preferred.
  • Conduct audits and analyses of revenue cycle processes to identify discrepancies, trends, and opportunities for improvement.
  • Provide training and support to staff regarding charge master updates, coding changes, and revenue integrity best practices.
  • Identify and implement process enhancements to optimize revenue capture and improve efficiency across the revenue cycle.
  • Ensures compliance with relevant regulations, standards and directives from regulatory agencies and third-party payers.
  • Review third-party payer contracts for optimization of net revenue
  • Complete provider insurance enrollment
  • Serves as a financial expert between billing, IT, and clinical teams for revenue integrity.
  • Accountable for complete, timely and accurate delivery of reporting functions.

Benefits

  • Access to Employer Direct Care Clinic. Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan.
  • Generous paid time off program beginning day one.
  • Medical Insurance: Your Choice of Two High Deductible Health Plan Options or a PPO, Dental and Vision Insurance. Coverage begins the first of the month after date of hire.
  • H S A with employer contribution for eligible health plans, FSA for qualifying medical and dependent care expenses.
  • Company Paid Life, Short Term and Long Term Disability Insurance.
  • Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance.
  • Industry leading retirement plan- employer contributions begin day one, no waiting period for participation.
  • Tuition Assistance Program.
  • Free onsite employee fitness center.
  • Discounted Child Care Program

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Industry

Ambulatory Health Care Services

Number of Employees

501-1,000 employees

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