Revenue Integrity Analyst

2 weeks ago

Boston, United States East Boston Neighborhood Health Center Full time
Revenue Integrity Analyst
Remote, Part-time

EBNHC seeking an experienced Revenue Integrity Analyst for remote position Under the direction of the Manager of Revenue Integrity and Payer Contracting, the Revenue Integrity Analyst will provide analytical support to proactively identify performance trends and propose solutions when needed.   This will require an extensive background working with MS Office, with an emphasis on Excel and Presentation programs.  The ideal candidate will be a self-starter with broad revenue cycle experience.  A key responsibility of this role will be leading projects and assessments prioritized by department leadership.  As part of ensuring operational integrity of the revenue cycle processes the position executes steps that support the maintenance and enhancement of all revenue cycle systems. Creates a positive, constructive, and supportive relationship between EBNHC departments, external partners, and personnel needed to resolve issues.  
Epic PB Resolute and medical billing experience is required for this position.  Strong verbal and written communication skills are needed to be successful in this role.

This position is a 100% remote work opportunity.  Proof of residency is required in one of the following States (Massachusetts, Maine, Tennessee, Wisconsin, Colorado, Georgia, Pennsylvania, Rhode Island, New Hampshire, Ohio, Michigan, or Florida).

Essential Duties and Responsibilities:
  • Communicate and coordinate resolution of identified issues with denials, payment variances and contract operations to leadership and other stakeholders.
  • Documents department workflow and assists periodic assessments to ensure efficient processes.
  • Tracks WQ performance to ensure timely processing of claims and     proactive identification of billing issues.
  • Direct and participate in complex projects related to revenue cycle initiatives.
  • Intermediate analytical skills to evaluate information gathered from multiple sources and synthesize into actionable information
  • Leads reconciliation for a wide variety of projects.  Plays key role in developing reconciliation policies.
  • Assists with charge master maintenance, including annual updates to ensure appropriate billings and maximization of revenue. 
  • Performs random audits of standard reports and performance measures for all areas of responsibility.
  • Keeps self and staff abreast of any changes in state and federal government programs, as well as all other third party payers.
  • Provides feedback to assist EBNHC management in developing strategies to improve patient financial service operations.

Qualifications and Requirements:
  • Bachelor’s degree or equivalent experience required, Masters Preferred.
  • 3+ years of healthcare experience required, including full scope revenue cycle, charge master, performance benchmarking
  • 3+ years of Epic experience required (PB Resolute)
  • Knowledge of insurance reimbursement policies, payer contracting, operations and billing regulations
  • Experience working with Clinic and Physician leadership
  • Knowledge of health care industry trends
  • Knowledge of Revenue codes, CPT, and ICD-10 Coding

Benefits:
  • Medical, Dental, and  Vision Coverage
  • Life and Disability Insurance
  • 401(K) Retirement Plan
  • Tuition Reimbursement
  • Flexible Spending and Transportation Accounts
  • Paid Holidays, Vacations, Sick, and  Personal Time
  • Generous Staff Development Benefit
  • Excellent Malpractice Coverage
  • Pet Insurance
  • Free Parking and much more

EBNHC opens our doors to people from all demographics and cultures. Our workforce is as diverse as the city we call home — in gender, race, ethnicity, sexual orientation, disability, religion, and age, as well as in cultural backgrounds, life experiences, thoughts, and ideas.

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