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Revenue Integrity Analyst

3 months ago

Salida, United States Heart of the Rockies Regional Medical Center Full time
Description

Position is remote eligible with minimum of 2 years Chargemaster experience.

ESSENTIAL DUTIES PER AREA OF RESPONSIBILITY

  1. Responsible for managing, coordinating, and implementing charge master (CDM) initiatives and processes to ensure revenue management and protection.
  2. Works closely with clinical departments to maintain and educate for optimum charge capture and compliant billing.
  3. Provides guidance to departments regarding strategic pricing services.
  4. Provides ongoing charge entry training and retraining as needed.
  5. Evaluates departmental CDM requests to insure that all additions, changes and deletions are consistent with proper hospital charging.
  6. Analyzes and resolves specific billing edits/errors that require clinical expertise and that are delaying claims for processing and reimbursement.
  7. Audits for missing charges.
  8. Manages Charge master Committee meetings to address challenges related to yearly coding changes, Medicare updates, charge capture opportunities and pricing.
  9. Serves as the principal point of contact for charging issues.
  10. Performs market analysis to determine reimbursement and pricing.
  11. Other duties as assigned.
QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  1. Applicant has a general understanding of the Revenue Cycle including: Department charging processes, charge master structures, Registration, Patient Accounting/Billing and Reimbursement.
  2. Computer, technical skills required, including: Excel, PowerPoint, CPSI, and Rycan.
  3. Good communication and customer service skills, including the ability to progressively investigate, analyze and identify sources of problems, provide practical solutions, and negotiate resolutions.
  4. Ability to make independent business decisions, considering both the impact to customer satisfaction and overall financial impact for the department and organization.
  1. Solid ability to handle highly confidential, sensitive information. Position requires a high level of professionalism, tact, discretion, and integrity.
  2. Must have the ability to work independently as well as collaboratively and adapt to changing priorities; demonstrate resourcefulness and good problem-solving skills.


Requirements

EDUCATION and/or EXPERIENCE

Minimum of 3 years' experience as an analyst in a healthcare environment with emphasis on chargemaster, revenue capture, charge auditing, reporting and reimbursement.

CERTIFICATES, LICENSES, REGISTRATIONS

None required.