Revenue Integrity Service Line Analyst
2 months ago
Wilshire hires only the brightest and most experienced professionals in the healthcare revenue cycle management industry. Wilshire will take the time to get know you and your employment history. We will then place you in a role that will lead to a path of career success.
**About The Wilshire Group**
The Wilshire Group, a renowned boutique consulting firm in Los Angeles, specializes in revenue cycle optimization and fostering effective collaboration between operational and IT facets. With a robust track record of aiding over 100 healthcare systems nationwide, our team thrives on professionalism, efficiency, and adaptability.
Our core values
- professionalism, efficiency, and flexibility
- underscore our commitment to creating an inclusive and dynamic workplace. We embrace diverse narratives and believe in offering opportunities to exceptional individuals who bring their best to the table.
We are currently offering a contracted interim position at one of US News Best Hospitals 2022-23. This position caters to top performers seeking a professional environment that acknowledges and values their dedication and proficiency. While this role doesn't offer benefits, it presents an opportunity to work within an organization that encourages talented individuals to surpass conventional boundaries.
Join us at The Wilshire Group, a place where talented professionals find a home to showcase their skills and contribute meaningfully to the healthcare landscape.
**Why Wilshire? Employee Testimonial**
**This is a contracted position for 12+ months. This positions offers 65% of fee sharing. Equivalent to $75.00-$100.00 per hour.**
**Revenue Integrity Service Line Analyst**
**Position Summary**:
The Revenue Integrity department has systemwide responsibilities for charge capture integrity for both hospital and professional services. Under the direct supervision of the Revenue Integrity Operations Manager, the Revenue Integrity Service line Analyst will be responsible for data collection, report production, and comprehensive financial analysis of information in support of Revenue Integrity's internal operations as well as revenue cycle functions at the organizational level. The employee will monitor, charge capture activities, and system interfaces between various charge capture systems, assist in charge automation initiatives, and collaborate with Revenue cycle business partners regarding programming enhancements, and system upgrades. Retrieves data for standard and ad hoc reporting as needed or requested. Analysis and reports will include trending, benchmarking, functional flows, and performance measures that identify deficiencies and improvements in the revenue cycle. The incumbent is the primary liaison for all revenue generation of services rendered and consistent with Revenue Integrity charging guidelines.
**Required Qualifications**:
- Skill to effectively work with all levels of health system personnel including directors and physicians
- Excellent written and verbal communication skills in English
- Experience working with hospital billing systems and knowledge of third-party billing requirements as well as knowledge of institutional and professional charging practice and charge automation functions which is typically obtained through 5 years' experience. In addition, one must know the automated patient account function and be familiar with Electronic Health Records interfaces, extrapolation of data, and charge processing.
- Skill in converting master files into reports for departmental use and in ad hoc technical report writing, complex analysis, and data conversion into different formats.
- Excellent computer skills and experience with a thorough working knowledge of Microsoft Access and Excel
- Extensive knowledge of split fee billing hospital outpatient charging and OPPS reimbursement
- Skill to read and correctly interpret governmental and commercial payor regulations and develop and implement recommendations consistent with interpretations
- Knowledge of provider and governmental processes
- Knowledge of HIPAA -Must have a working knowledge of Current Procedural Terminology (CPT) and Diagnosis (ICD-10) codes Preferred Qualifications:
- Knowledge of Structure Query Language (SQL)
- CPC-H, CPC or equivalent coding certification
- Knowledge of Tableau
- Bachelor's degree in business, Finance, or related field
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