Sr. Analyst, Revenue Integrity, Procedural Supply Governance

Northwestern Memorial Healthcare • Warrenville, IL

18d • $40 - $58

About The Position

The Senior Analyst, Revenue Integrity, Procedural Supply Governance supports clinical departments and the revenue cycle through charge capture analysis, including annual price increase analysis. The role helps maintain Northwestern Medicine’s charge master to ensure compliance, accuracy, and consistency, and prepares analysis and support for management and clinical departments. The position also supports finance, operations, and revenue cycle teams through special projects while protecting confidential financial and patient information. It reflects Northwestern Medicine’s mission, vision, and values and adheres to its Code of Ethics, Corporate Compliance Program, policies, procedures, and applicable regulatory and accreditation standards.

Requirements

• Bachelor’s degree in Business or a related field, or 10 years of equivalent experience with progressive advancement.
• Five or more years in a revenue cycle or revenue integrity role.
• Proficiency with the Microsoft Office suite.
• Advanced understanding of CPT, HCPCS, ICD-10, and third-party billing requirements.
• Extensive knowledge of and experience with Medicare and Medicaid regulations.
• Strong communication, collaboration, and analytical skills.
• Critical thinking, decisive judgment, high attention to detail, and ability to work with minimal supervision.
• Knowledge of computer applications, including databases, spreadsheets, and word processing applications, in a high-complexity environment.

Nice To Haves

• EPIC Certification (Resolute Charge Capture).
• EPIC Certification (Clarity Report Data).
• Master’s degree in Healthcare Management, Business, MIS, Data Analytics, or a related field.
• Beginner to moderate knowledge of SQL and relational databases.
• RHIA or a related healthcare credential, such as radiology technician or RN.

Responsibilities

• Perform daily maintenance and quarterly audits of the EAP.
• Prepare files required for department builds in the EAP database.
• Proactively identify charge capture opportunities in revenue-producing departments.
• Research and interpret billing and coding regulations, communicate them to impacted areas, and apply changes affecting policy, finances, charge capture, patient care, billing, and coding operations.
• Lead quarterly audits of charge master data elements.
• Review departmental front-end charge capture tools for accuracy.
• Lead complex audits and prepare methodology for annual pricing and coding changes.
• Troubleshoot complex account errors and educate Revenue Managers on their resolution.
• Resolve questions related to charge capture and complex regulatory billing issues, including Provider-Based status rules, OPPS, CCI, and MUE.
• Liaise with Revenue Cycle, IT, and clinical departments to link EPIC and the charge master.
• Research, compile, and analyze financial data, and organize and maintain database files for financial modeling.
• Mentor and support Revenue Integrity Team members as an informal leader.
• Lead efforts to assess, modify, or develop and implement processes and systems that improve timeliness, consistency, efficiency, accuracy, and the usefulness of information.
• Maintain professional and technical knowledge through educational workshops, professional publications, personal networks, industry best practices, and participation in professional societies.
• Support finance, operations, and revenue cycle teams through special projects.
• Protect operations by keeping financial and patient information confidential.
• Support Northwestern Medicine’s finance operation.

Benefits

• Tuition reimbursement.
• Loan forgiveness.
• 401(k) matching.
• A wide range of benefits supporting employees’ physical, emotional, and financial well-being and protection for unexpected life events.

What This Job Offers

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