Revenue Integrity Analyst

1 week ago

Lewisville, United States BayMark Health Services Full time
Description

Position at BayMark Health Services

Revenue Integrity Analyst

Lewisville, TX

The Revenue Integrity Analyst is an essential part of BayMark's Compliance Program. The Revenue Integrity Analyst is responsible for maintaining and assessing the Patient Financial Services (PFS) billing compliance program. This individual performs audits as well as reviews of PFS and Reimbursement activities to ensure compliance. This position is responsible for developing trainings as well as conducting the trainings of PFS and reimbursement activities. The Revenue Integrity Analyst will coordinate the Company's pre-billing review process and random quality control audit reviews to assure adherence to documentation standards and all federal and state regulations relevant to the Company.

Essential Job Functions

  • Ensure regulatory compliance for medical documentation, coding and billing requirements.
  • Develop and implement billing compliance policies and procedures, as needed.
  • Develop and implement billing compliance training to employees and other pertinent individuals (i.e. independent contractors, consultants, etc.) Develop training reports to ensure adherence to training requirements.
  • Develop, implement and coordinate the billing compliance monitoring and auditing processes, including but not limited to, conducting audits and billing compliance risk assessments, analyzing results, identifying deficiencies, developing reports and formulating recommendations for corrective action.
  • Responsible for reporting to governmental agencies in accordance with company policies and procedures.
  • Analyze government and/or public policy and alert the Company to trends and risks associated with coding and billing.
  • Perform due diligence on potential acquisition targets as well as oversight for initiating new compliance programs with newly acquired organizations.
  • Ability to handle stressful situations and interact with others.
  • Must be present during working hours at the office for in person meetings and access to a computer without violating company policy.
  • Work on additional projects/duties as assigned.
  • Other duties, as assigned.
Minimum Qualifications
  • Bachelor's degree in Business Administration, Finance, Economics or similar major is preferred.
  • One or more certifications as Certified Professional Coding (CPC) and/or Certified Coding
    • Specialist-Professional (CCS-P).
  • A minimum of five years of experience in a healthcare organization compliance/auditing or healthcare compliance (experience with billing, claims process, Medicaid, Medicare, ACA, medical record review, investigation of problematic issues).
  • Strong project management skills and experience required.
  • Strong acumen and understanding of healthcare, healthcare regulations, laws, and governmental compliance program guidance.
  • Strong knowledge of MS Office, including Word, Excel, PowerPoint SharePoint, HER and Visio as well as online/Internet-based research tools.
  • Experience with managed care, Medicare and federal and/or state regulations and quality improvement.
  • The utmost integrity in the discreet and confidential handling of confidential materials is necessary.
  • The ability to comprehend and interpret regulatory, legislative, and contractual mandates.
  • Healthcare Internal Audit Certification preferred.
  • Ability to function independently with limited direction.
  • Excellent interpersonal skills with a high level of diplomacy and political awareness, and ability to work effectively as a member of the senior management team.
  • Must possess strong analytical and problem solving skills.
  • Exceptional oral and written communication skills.
  • Exceptionally detail-oriented.
  • Demonstrate ability to meet deadlines.
  • Must have the ability to multitask.
  • Must be able to operate effectively in a fast-paced environment with attention to detail.
  • Satisfactory references from employers and/or professional peers.
  • Satisfactory criminal background check.
  • Satisfactory drug screen.
Benefits:
  • Competitive salary
  • Comprehensive benefits package including medical, dental, vision and 401(K)
  • Generous paid time off accrual
  • Excellent growth and development opportunities
  • Satisfying and rewarding work striving to overcome the opioid epidemic


Here is what you can expect from us:

BayMark Health Services specializes in the treatment of opioid addiction. BayMark Health Services provides medication-assisted treatment services in a variety of modalities and settings through our divisions: BAART Community HealthCare, Health Care Resource Centers and MedMark Services, Inc. BayMark Health Services, also provides traditional primary health care services, as well as integrated primary care, in select locations.

BayMark Health Services is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws.

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