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Senior Revenue Integrity Analyst

2 months ago

Tampa, Florida, United States Moffitt Cancer Center Full time

About Moffitt Cancer Center
At Moffitt Cancer Center, we are dedicated to leading the way in understanding cancer's complexities and utilizing this knowledge to aid in its prevention and treatment. Our diverse workforce of over 9,000 individuals is committed to serving our patients and fostering an environment where every team member is valued and acknowledged. Moffitt has received accolades such as being listed among America's Best Large Employers and Best Employers for Women by Forbes in 2023, and recognized as one of the top workplaces by various esteemed publications.

Position Overview
Moffitt Cancer Center is currently seeking a Senior Revenue Integrity Analyst. This full-time remote position is available for residents in select states. The role focuses on ensuring accurate charge capture and billing processes to optimize reimbursement through effective management of coding initiatives.

Key Responsibilities:

  • Conduct analysis of Correct Coding Initiatives (CCI) and Outpatient Code Editor (OCE) edits to identify trends and charge capture opportunities.
  • Review and finalize coding for complex edits.
  • Analyze the relationship between coding edits and departmental charge reports on a monthly basis.
  • Evaluate the impact of coding changes pre- and post-implementation.
  • Facilitate timely resolution of billing issues, denials, and charge capture challenges.
  • Maintain the Master Transaction Catalog within the financial system.
  • Identify and rectify missing or incorrect charge codes.
  • Collaborate with management to enhance processes for updating charge codes.
  • Investigate root causes of issues related to coding edits for potential automation.
  • Work with clinical staff and revenue cycle departments to develop charge codes for new procedures.
  • Assist with special projects as assigned.
  • Participate in training initiatives regarding clinical documentation to enhance charge optimization.
  • Demonstrate proficiency in interpreting and implementing Medicare regulations.
  • Possess a strong understanding of financial data related to billing and reimbursement.
  • Exhibit knowledge of charge development processes and their interrelation with cost management functions.
  • Understand various payment and coding systems, including OPPS and HCPCS.
  • Familiarity with hospital and professional claims forms.
  • Address compliance issues related to charging processes through research and adherence to guidelines.
Qualifications:
Experience:
  • A minimum of four years of experience in a related healthcare field is required, which may include clinical roles, coding, provider billing, or patient accounting.
  • A High School Diploma or equivalent, along with five additional years of relevant experience, may substitute for a bachelor's degree.
  • At least one year of experience in a healthcare provider setting is preferred.
Preferred Qualifications:
  • Experience with Cerner and Soarian applications.
  • Familiarity with coding and Charge Description Master (CDM) maintenance.
Education:
  • A Bachelor's Degree in Nursing, Finance, HIM/Coding, Healthcare, or Business Administration is preferred.
  • A Master's Degree in a related field is also desirable.
Licensure/Certification:
  • Possession of relevant certifications such as Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is required.
Equal Opportunity Employer
Moffitt Cancer Center is an Equal Opportunity/Affirmative Action Employer. We value diversity and encourage all qualified applicants to apply.