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Acute Intermediate Revenue Integrity Analyst
4 months ago
**Primary City/State**:
Arizona, Arizona
**Department Name**:
Revenue Integrity-Corp
**Work Shift**:
Day
**Job Category**:
Revenue Cycle
Revenue Integrity has become a leading national focus to gain greater visibility for sound financial outcomes/practices, compliance and optimal reimbursement with focus across all continuums of patient care. Revenue Integrity in an integral part of the Revenue Cycle and covers all essentials related to it. We have teams comprised of Charge Capture, Pre-bill, Post-bill and Monitoring (Auditing). RI also utilizes technology to enhance achievement along with an added focus where necessary that may include high dollar accounts, denials, improved A/R days and cash flow while collaborating with many areas such as Billing, Coding, CDM Services Expected reimbursement
As an Acute Intermediate Revenue Integrity Analyst you will work with a variety of claims, correcting coding or charging errors that may prevent a bill from going to the payer. You will have an opportunity to work for a team that provides, flexibility and many growth opportunities.
**Desired background: Revenue integrity/ Charge OR Coding**
**Acute Hospital experience needed**
**This can be a remote position if you live in the following state(s) only: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR PA, SC, TN, TX, UT, VA, WA, WI, WV**
This position, under the direction of the Revenue Integrity Director, is responsible for managing, coordinating, and implementing charge capture initiatives and processes to improve revenue management and revenue protection. This position is responsible to discover revenue issue root cause and to develop correction action plan and provide charge capture education. In addition, recommend modifications to established practices and procedures or system functionality as needed to support revenue cycle and manage implementation of the recommended changes. This position will work with internal customers to ensure newly implemented workflows and procedures support revenue cycle integrity and to achieve revenue cycle’s financial goals.
CORE FUNCTIONS
1. Acts as liaison between physician practices and coding to provide oversight and communicate provider charge capture performance. Closely aligns with physician coding to support the physician practice in achieving a healthy revenue stream. Partners with Coding, Cerner Clinical Informatics and Revenue Cycle teams to ensure an uninterrupted revenue cycle and support performance improvement opportunities.
2. Partners with physician practice leaders to provide oversight on open encounters and unsigned orders for a positive impact on timeliness of charges and ultimately the revenue cycle. Ensures new lines of service are communicated and set up proactively. Coordinates department requested CDM charge additions and deletions as applicable.
3. Identifies areas of risks and opportunities to improve compliance and revenue management. Monitors and resolves audit work queues, proactively identifies revenue opportunity and suggests improvements. Maintains knowledge of current coding and documentation requirements as required for compliant billing.
4. Collaborates with Clinical Informatics to provide feedback, training and education to providers regarding standardized charge capture workflows. Develops automated processes to replace manual workflow when able.
6. Collaborates with Revenue Integrity Director to develop and generate standardized reporting templates for revenue integrity KPI dashboard and daily/weekly analytics. Analyzes and quantifies analytics dashboard results. Prepares timely and accurate reports for presentation to departments, senior leadership, Revenue Integrity and Continuous Improvement forums to support prevention of lost revenue. Escalates variances and collaborates with stakeholders for resolution and process improvement as indicated.
7. Reviews charging performance against standards and trends. Works with stakeholders to identify root cause and implement solution to remediate charge capture issues. Works with a variety of departments including senior leadership, physician practice, finance, coding, and revenue cycle to assist with data gathering and/or interpretation. Ensures the integrity of reports and databases used for Revenue Integrity.
8. Provides support for special projects assigned to the department by management for analysis. Brings strength in logic and analysis of data, sorts through data and determines which elements are pertinent to the project. Identifies and recognizes trends, presents data and analysis results to appropriate parties.
9. Works independently under general supervision and direction of the Revenue Integrity Director. Collaborates with Physician Department Leadership, Administration, Data Operations, Finance, Patient Access Services, Coding, and Patient Financial Services. Provides management with accurate and timely info
