Senior Revenue Integrity Specialist

Arkansas Children's Hospital•Little Rock, AR

1d•Hybrid

About The Position

The Senior Revenue Integrity Specialist performs daily monitoring and reporting analysis related to the revenue cycle independently. Recommends modifications to established practices and procedures or system functionality as needed to support revenue cycle. The analyst will work with internal customers to ensure newly implemented workflows and procedures support revenue cycle integrity and to achieve revenue cycle’s financial goals. Communicates any issues to the Director of Cost Analysis. Conducts charge capture audits to identify revenue leakage and charge accuracy. Assists with the maintenance of an accurate and complete charge master ensuring appropriate reimbursement and compliance with governmental billing regulations. Maintains working knowledge of CPT and HCPCS coding as well as billing and other relevant coding/ billing guidelines. Performs special projects and analysis as needed.

Requirements

Bachelors Degree or Equivalent Experience
Accounting - 6 years of experience

Nice To Haves

Resolute Hosp. Billing Integrity (ARCR) - EPIC Systems Corp.

Responsibilities

Oversees charge capture and reconciliation processes and provides education for new services added. Works with various departments to ensure appropriate charge capture. Conducts charge capture audits to identify revenue leakage and charge accuracy.
Works with internal customers to ensure newly implemented workflows and procedures support revenue cycle integrity and achieve the revenue cycle's financial goals. Collaborates with IT to ensure all cross walk, mapping, interfaces, etc. are set up correctly for appropriate charge capture and billing. Participates on various committees for changes designed to automate, optimize, and enhance revenue cycle integrity.
Performs daily review of charge items and revenue integrity work queues to ensure accurate and timely resolutions.
Performs appropriate follow-ups when unusual items are noted and ensure problems are resolved and prevented in the future.
Performs audits of tests/procedures performed vs. items reported in Hospital Information System to ensure daily charge reconciliations are accurate.
Responsible for the accuracy and timely setup and maintenance of patient charges for CPT code integrity in compliance of regulatory guidelines along with the consistency and integrity of pricing methodology. Performs annual update of CPT codes for assigned departments to ensure compliance with regulatory guidelines.
Coordinates with assigned hospital department heads to gain understanding of clinical services provided and interpret into patient charges.
Performs analysis of market data to ensure competitiveness of new and existing patient charges.
Performs advanced level analysis of issues involving charge set up for new and existing patient charges, investigate causes, propose solutions and reports findings to Cost Accounting Director.
Assists with the maintenance and accuracy of the cost accounting system by coordinating with assigned hospital depratment heads to gain understanding of clinical services provided and interpret into financial standard costs.
Assists with the accurate and timely setup and maintenance of the procedural standard costs components in the Strata Cost Accounting System.
Other duties as assigned.