Revenue Integrity Analyst

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Job Description:

The Revenue Integrity Analyst plays an important role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation. Due to its service focus and project management emphasis, the position requires strong interpersonal and communication skills, well-developed analytical and organizational skills, and the ability to meet deadlines while influencing, but not directly managing the work of others. Minimum Qualifications ◾ Education Certified coder with a minimum of 2-3 years of recent experience preferred, or meaningful experience in healthcare finance, CDM maintenance, charge auditing, revenue cycle or other related field required. ◾ Credentials Dual Hospital and Professional Coding Certification(s) preferred (CPC, CPC-H, CCS, CCSP, RHIT). Work Environment Office setting with standard office desks and/or cubicles. Continuous use of computer and photocopy machine. Works with frequent interruptions. Physical Demands Stand and/or walk frequently. Sit frequently. No lift and/or carry. Bends, reaches and stoops occasionally . No push and/or pull. Visual acuity, ability to speak and hear, manual dexterity within normal limits. Computer use frequently.

 

 

Essential Functions Performs CDM /related audits with a focus on revenue cycle integrity, seeking guidance from RC Analyst and Management when needed; Evaluates current charging and coding structures and processes in clinical departments to ensure appropriate capture and reporting of revenue and compliance with government and third party payor requirements. Assess accuracy of all charging vehicles, including clinical system and dictionaries, encounter forms and other charge documents; Provides guidance, communication and education on correct charge capture, coding and billing processes to multiple clinical departments and facilities; Participates in projects related to revenue cycle initiatives with a degree of autonomy appropriate to experience and project complexity; Analyzes billing error and denial data to identify root causes; executes work plans to correct identified deficiencies; Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars and publications; executes work plans to adapt systems and processes to accommodate such changes; Works with RC Data Analyst and Patient Accounts to review billing edits and work with clinical departments to provide education on correct charge entry and payer billing/coding rules.; Monitors charge reconciliation reports to identify trends including compliance issues, missing charges and areas of vulnerability; Additional duties as assigned.

 

Join us. Join great. Join the dynamic team at Great Plains Health and be a part of something truly exceptional. At Great Plains Health, we embody a culture defined by authenticity, integrity, and a genuine commitment to listening to both our patients and each other.

As a member of our team, you'll experience a supportive environment where collaboration is key, and every voice is valued. We work together seamlessly, leveraging our collective strengths to provide the highest quality care to our community.

Passion drives us forward, propelling us to constantly strive for excellence in everything we do. If you're seeking a rewarding career in healthcare surrounded by like-minded individuals who share your dedication and enthusiasm, Great Plains Health is the place for you. Come join us and be part of a team that's making a real difference every day.