Revenue Integrity Regulatory Analyst

2 weeks ago

Greenfield, United States Hancock Regional Hospital Full time
Category
Patient Financial Services

Description

JOB SUMMARY: The Revenue Integrity Regulatory Analyst will be a member of the Patient Financial Services Revenue Integrity Team. Daily, this team member will help to resolve revenue cycle issues as they relate to billing and reimbursement. In addition to working with members of the revenue integrity team,the regulatory analyst will serve as a liaison between Hancock revenue integrity staff and payors. It will be their responsibility to research and interpret governmental and third-party payer regulations. In addition, the team member in this position will be responsible for educating Hancock Regional's revenue cycle staff on all pertinent reimbursement regulatory measures, updates, and changes to ensure organization-wide compliance. In addition, the regulatory analyst may be called to assist with process improvement strategies to prevent denials and missed reimbursement. The Revenue Integrity Regulatory Analyst must be self-driven and able to multitask and prioritize their work. They must have strong communication skills with an understanding of reimbursement methodologies and be able to deal effectively with others. This position is team-oriented and contributes to achieving department goals.

QUALIFICATIONS:

JOB SPECIFIC CORE COMPETENCIES:
  • Maintains demeanor that is customer service-oriented, with a patient first attitude.
  • Exhibits excellent written and verbal communication skills.
  • Demonstrates understanding of coding terms, reimbursement methodologies and processes
  • Monitors and communicates all revised and or new communications/regulations from commercial and government payers
  • Demonstrates the ability to communicate all applicable regulatory information and updates with other department leads and staff throughout the organization in a friendly, professional, and timely manner.
  • Develops and/or modifies payer specific policies and procedure for the facility to ensure all reimbursement regulatory requirements are met
  • Maintains good working relationships with all external payer representatives in order to address reimbursement issues impacting Hancock Health
  • Will stay apprised of network contracts to assess their impact on reimbursement to Hancock Health
  • Ability to multitask and maintain a strong attention to detail, with good analytical and problem-solving skills
  • Proficiency in Microsoft Office suite (Outlook, Excel, Word); experience with Meditech preferred but not required.
  • Ability to function independently and as a team player in a fast-paced environment
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

Communication
  • Dedicated to providing best first impressions for our patients, physicians, and associates
  • Maintains communication and acts as a liaison between the Patient Financial Department, clinical and administrative partners within the health network, as well as external constituents/stakeholders
  • Maintains a high regard for confidentiality and abides by organizational and HIPAA guidelines, privacy practices, patient confidentiality, and patient rights
Technical
  • Demonstrates knowledge of medical terminology.
  • Will have a good understanding of Reimbursement Strategies and Analytics
  • Ability to understand and explain complex payer regulations and design internal policies to ensure compliance
  • Works independently and must be self-motivated.
  • Will analyze and report on current reimbursement issues
  • Demonstrates the ability to embrace and adapt to change and regularly initiates ideas to improve the revenue cycle efficiency and revenue integrity processes of the department.
  • Functions as an integrated revenue integrity team member and works collaboratively with other staff
  • Maintains Extensive knowledge of current healthcare trends, policies, and regulations
  • Exhibits in-depth knowledge of compliance regulations as they relate to documentation, coding, and billing requirements
  • Displays a thorough understanding of revenue integrity processes and their impact throughout the revenue cycle
  • Displays understanding of coding classifications and reimbursement systems such as, but not limited to, ICD-10-CM, NCCI, CPT-4, HCPC, DRG, ffs, OPPS and APC's.
  • Has adept analytical skills, and a proven ability to develop effective solutions for complex business challenges
  • Comprehensive understanding of computer, database, and network technologies
  • Exceptional verbal, interpersonal, and written communication skills
  • Effective at adjusting to change, prioritizing duties, and handling stress
  • Strong project management and time management skills
  • Performs other duties as assigned
Position Requirements

EXPECTED BEHAVIORS:

Attitude/Customer Competencies
  • Caring, compassionate, and approachable in all customer and peer contacts
  • Privacy - respects customer and peer's right to privacy
  • Confidentiality - maintains customer and peer's confidentiality
  • Initiative - takes necessary steps to fix problems immediately
  • Providing Direction and Acknowledgment - provides personalized attention by being courteous, friendly, and helpful when responding to customer and peer's needs
  • Timely service - recognizes that customers and peer's time is very valuable; provides them with prompt service
Relationship Competencies/Work Group Competencies
  • Demonstrates advocacy, respect and truth telling
  • Demonstrates accountability for own actions
  • Demonstrates the ability to respectfully address interpersonal conflicts
  • Takes initiative to help others
  • Demonstrates a learning attitude toward solving problems
  • Demonstrates openness to change and new learning
    •Reports to work on time and has regular attendance
  • Adheres to facility defined dress code
  • Attends all staff meetings
Ethical Decision-Making
  • Respects the needs, expectations, and rights of all individuals
  • Advocates the rights of all to a safe environment
MANDATORY LICENSE/REGISTRATION/CERTIFICATION:

CERTIFICATION/LICENSE:

NONE

EDUCATION AND EXPERIENCE REQUIREMENTS:
  • Bachelor's degree in business, health/science, law, public administration, management, or a related field required
  • Three to five years of experience in a medical related field dealing with revenue cycle activities required
  • utilizing knowledge of medical terminology, CPT, HCPC, and ICD10 codes,
  • utilizing common healthcare payment methodologies such as DRG, Medicare OPPS APC classifications, and Fee For Service
  • Experience in interpreting and working with business contracts and legal documentation
  • Experience with research and analysis
Full-Time/Part-Time
Full-Time

Shift
Days

Resubmittal due to closure after 120 days open?

Number of Openings

Exempt/Non-Exempt

Position
Revenue Integrity Regulatory Analyst (755)

Number of Openings
1

Exempt/Non-Exempt
Exempt

Open Date
2/9/2024

Location
Hancock Regional Hospital

About the Organization
YOUR HEALTH IS OUR LIFE

Hancock Health is an Indiana-based, full-service healthcare network serving Hancock County and the surrounding areas. Our health system includes Hancock Regional Hospital, Hancock Physician Network and more than 20 other healthcare facilities, such as wellness centers, women's clinics, family practices, and the Sue Ann Wortman Cancer Center.

A Caring Community Partner
Our goal at Hancock Health is simple: To give every person the personalized attention necessary for a happy, healthy life. Our mission, vision, and values embody this goal.

OUR MISSION
To be a Caring Community Partner by healing, improving health and wellness, alleviating suffering, and delivering acts of kindness one person at a time.

OUR VISION
To be nationally recognized for kindness in the delivery of excellent quality patient care, efficient and effective operations, the adoption of proven technologies, the creation of a positive workplace environment, and excellence in community service.

OUR VALUES
Exceptional | Honorable | Devoted | Reliable | Kind

EOE Statement
We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.

This position is currently accepting applications.

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