Senior Revenue Integrity Analyst

Facility:

Work from Home - Hybrid - Ohio

Department:

Revenue Integrity Services

Schedule:

Full time

Hours:

40

Job Details:

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.

Department Specific Job Details:

Education

• Bachelor’s degree in Health Information Management, Finance or related field required
• Masters preferred

Experience 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)

Preferred qualifications/skills

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

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