Revenue Integrity Analyst

4 weeks ago

Boston, United States East Boston Neighborhood Health Center Full time

Thank you for your interest in careers at EBNHCEverywhere you turn, you can feel it. There's an immeasurable level of enthusiasm at East Boston Neighborhood Health Center (EBNHC), one of the largest community health centers in the country. From the nurses and physicians on the front line of patient care, to the managers who shape our policies, to the customer service representatives who keep our facilities running smoothly - everyone here has a role in making medicine better.Interested in this position? Apply on-line and create a personal candidate account Current Employees of EBNHC - Please use the internal careers portal to apply for positions.To learn more about working at EBNHC and our benefits, check out our Careers Page at careers.ebnhc.org. Time Type Full time Department Patient Accounts All Locations: East Boston Description 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, 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 Bachelors 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

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