Revenue Integrity Analyst
Details:
• Works with Managers of Revenue generating departments to ensure services are appropriately, accurately and consistently accounted for daily and deductions from revenues are minimized. This will be accomplished through a thorough knowledge and accurate set up of the Charge Master, regular charge audits, knowledge of governmental regulations and other payor contract requirements followed by ongoing communication and training.
• Design, plan, organize, and direct orientation programs for employees in Revenue and Documentation Integrity, specifically around requirements based upon the following: National Coverage Determination (NCD), Local Coverage Determination (LCD), Recovery Audit Contractor (RAC) and Additional Documentation Requests (ADR) as well as other process and policy documentation requirements and improvements.
• Determine training needs through charge audits, surveys, interviews with employees, or consultation with managers
• Work with Managers to obtain, organize, or develop training procedure manuals, guides, or course materials, such as handouts or visual materials for charge capture and daily audit routines using resources like the CMS Learning Center as appropriate.
• Takes responsibility for working with Managers to develop processes to ensure accurate and appropriate documentation to support coding and billing efforts as necessary
• Functions as a key member of the Finance Team and supports the Team by completing whatever projects or tasks necessary to meet required deadlines including Budgets, compiling information for the year-end Audit or Cost Report, various financial analyses and reporting.
Requirements:
• 5 years of healthcare experience (required)
• Bachelor’s degree in Accounting, Finance, Data Analytics, Computer Science, Healthcare Administration or related field (required)
• Master’s degree in Accounting, Finance, Data Analytics, Computer Science, Healthcare Administration or related field (preferred)
• Healthcare revenue cycle/charge master setup experience
• Knowledge of CPT, HPCS, ICD10 and UB revenue codes
• Excellent organizational and communication skills
• Ability to analyze large amounts of data and working knowledge of EHR system