Senior Revenue Integrity Analyst

Dayton Children's Hospital • Work from Home - Hybrid - Ohio, OH

1d • Hybrid

About The Position

The senior revenue integrity analyst is responsible for planning and oversight of the revenue integrity analysts’ performance of essential department accountabilities, including reporting to department leadership about goal status. This position will be responsible for all aspects related to revenue integrity, including maintaining work queues, understanding, and applying yearly regulatory changes, maintaining the chargemaster, and preventing revenue leakage. The senior revenue integrity analyst works accounts in assigned Revenue Integrity work queues to facilitate accurate, compliant billing of patient accounts and assists revenue integrity analysts with completion of tasks and work queues. The position will be certified in Epic CDM Management/Revenue Integrity to create, edit, delete and research various CDM requests for all hospital departments for both hospital and professional billing. The senior analyst is responsible for establishing and enforcing the hospitals’ pricing, coding, and regulatory changes. The incumbent needs to have knowledge of how billing and the CDM interacts for chargemaster build and will assist in hospital decision making related to chargemaster requests. The position will also provide operational analytical support with regards to reimbursement, charge lag, revenue trends, and other revenue related items. The senior revenue integrity analyst will coordinate and collaborate the above actions with, but not limited to, Health Information Management, Information Systems, Billing, Finance and Operations.

Requirements

• Bachelor’s degree in Health Information Management, Finance or related field required
• 6-10 years of revenue integrity, analyst, etc. experience in healthcare
• Experience with EPIC electronic health record
• EPIC CDM/Revenue Integrity (HB and PB) certification within 6 months of employment required
• Ability to research CPT and regulatory requirements
• Experience with CPT and HCPCS codes and interpreting CPT guidance
• Experience in healthcare billing, CMS Medicare and Medicaid reimbursement methodologies
• Proficiency in Microsoft Office Tools (Outlook, Excel)

Nice To Haves

• Masters preferred
• Trisus (Craneware) chargemaster experience
• Strata experience
• Registered Health Information Administrator (RHIA) Certification

Responsibilities

• Planning and oversight of the revenue integrity analysts’ performance of essential department accountabilities
• Reporting to department leadership about goal status
• Maintaining work queues
• Understanding and applying yearly regulatory changes
• Maintaining the chargemaster
• Preventing revenue leakage
• Working accounts in assigned Revenue Integrity work queues to facilitate accurate, compliant billing of patient accounts
• Assisting revenue integrity analysts with completion of tasks and work queues
• Creating, editing, deleting and researching various CDM requests for all hospital departments for both hospital and professional billing
• Establishing and enforcing the hospitals’ pricing, coding, and regulatory changes
• Providing operational analytical support with regards to reimbursement, charge lag, revenue trends, and other revenue related items
• Coordinating and collaborating actions with Health Information Management, Information Systems, Billing, Finance and Operations

Benefits

• We commit to safety - We ensure every action and decision prioritizes the safety of patients, families, and employees.
• We serve with compassion - We bring generosity, empathy, and kindness to all interactions.
• We own every moment - We take pride in everything we do.
• We’re better together - We collaborate, communicate, and support one another to deliver optimal care.
• We innovate with purpose - We adapt and change to improve pediatric care, for today and tomorrow.
• We value and respect each person - We create an inclusive space where everyone feels welcome and respected.
• Dayton Children’s is proud to be an Equal Opportunity Employer that values diversity and will not discriminate against minorities, women, protected veterans, individuals with disabilities, or based on age, color, gender identity, national origin, race, religion, sex, sexual orientation, or transgender status.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior