Senior Revenue Integrity Analyst - FT - Days - MHS

Memorial Healthcare

5d•Onsite

About The Position

The Revenue Integrity Senior Analyst is responsible for managing and configuring Memorial Healthcare System’s complex applications to support organizational needs, including design, development, testing, and implementation of system rules and requirements. This role serves as a lead resource for Revenue Integrity services, ensuring reimbursement, charge capture, and billing processes remain accurate and compliant with monthly, quarterly, and annual updates. In collaboration with end users and department leaders, the Senior Analyst provides guidance, communication, and technical expertise to maintain efficient and compliant revenue operations.

Requirements

Bachelors (Required)
Epic Charge Router Certification (EPIC CHG ROUTER) - EPIC Certification (EPIC)
Epic Resolute Billing Certification (EPIC BILLING) - EPIC Certification (EPIC)
Proficient in CPT/HCPCS/ICD 10-CM coding, Microsoft Office products, and hospital billing systems.
Minimum of three (3) years working with the Epic Resolute Hospital Billing system in a large multi-hospital organization.
Must have or be pursuing a coding credential from the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC), which must be obtained within 12 months from the date of hire.
Bachelor’s degree in Healthcare Administration or a related field with a minimum of three (3) years of relevant work experience OR Associate's degree in Healthcare Administration or a related field with a minimum of five (5) years of relevant work experience.
Minimum of three (3) years of experience in revenue cycle, oncology billing and/or coding, charge auditing, and/or cancer care.

Nice To Haves

Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) preferred.
Prior experience with the Aria oncology platform for managing patient data, treatment planning, and clinical workflows in cancer care.

Responsibilities

Performs root-cause analysis and collaborates with departments for corrective actions.
Organizes data and written information into draft projects and proposals.
Analyzes business and business processes and data to identify opportunities and improve existing processes using information technology.
Builds custom Work Queues, Revenue Guardian tools, and Charge Router/Handler rules to detect and prevent errors.
Designs and runs projects independently, meeting with department leaders and staff, and developing strategies to solve charging and billing issues.
Serves as a liaison between Revenue Integrity team and customers.
Leads or oversees an entire business application module or system, providing mentorship and guidance to junior administrators to develop technical expertise.
Provides expert and creative solutions by building new user requirements, functionality, or enhancements to drive efficiency, optimal functionality, and end‑user satisfaction.
Maps revenue and UOS to correct GL accounts to ensure internal and external reporting is accurate.
Conducts regular audits to ensure the timeliness and accuracy of charging and billing.
Audits and reviews all CPT, HCPCS, and revenue codes prior to EAP build.
Maintains data integrity when manipulating data files for purposes of analysis.
Ensures data does not become corrupted in any way when performing analyses, through conscientious use of tools and a system of checks and balances.
Spot-checks results of queries and reports to ensure meeting expectations before presenting finalized information.
Runs data multiple ways to ensure accuracy of results.
Ensures new software releases of the Epic system are set up correctly to prevent disruption or error in charge capture.
Provides training and guidance to Epic Clinical Department teams to ensure proper use of EAP codes.