Senior Revenue Integrity Analyst

2 weeks ago

Tampa, Florida, United States Moffitt Cancer Center Full time

About Moffitt Cancer Center
At Moffitt Cancer Center, we are dedicated to advancing the understanding of cancer and leveraging this knowledge to aid in its prevention and treatment. Our diverse workforce of over 9,000 individuals is committed to providing exceptional care to our patients while fostering an inclusive workplace where every employee is valued. Moffitt has been recognized as one of America’s Best Large Employers and Best Employers for Women by Forbes in 2023, and has consistently ranked among the top workplaces in the Tampa Bay area.

Position Overview
Moffitt Cancer Center is seeking a Senior Revenue Integrity Analyst. This full-time remote position is available to residents in select states, offering flexibility in work arrangements.

Key Responsibilities:

  • Conduct thorough reviews of Correct Coding Initiatives (CCI) and Outpatient Code Editor (OCE) edits to identify trends and opportunities for charge capture.
  • Perform coding for complex edits and analyze the relationship between coding adjustments and departmental charge reports.
  • Evaluate the effects of coding modifications pre- and post-implementation.
  • Facilitate the resolution of billing issues, denials, and charge capture discrepancies in a timely manner.
  • Maintain the Master Transaction Catalog within the Financial System, ensuring accuracy and currency.
  • Identify and rectify missing or incorrect charge codes within designated clinical areas.
  • Collaborate with management to enhance processes for updating charge codes.
  • Investigate root causes of coding issues and explore automation opportunities.
  • Work closely with clinical staff and revenue cycle departments to develop charge codes for new procedures.
  • Assist with special projects as needed.
  • Engage in training and educational initiatives to promote optimal clinical documentation practices.
  • Demonstrate proficiency in interpreting and implementing Medicare regulations.
  • Exhibit a strong understanding of financial data related to billing and reimbursement.
  • Possess knowledge of the charge development process and its connection to cost accounting and management.
  • Maintain familiarity with various payment and coding systems, including OPPS, HCPCS, and CPT coding schemes.
  • Understand compliance issues related to charging processes and provide solutions through research and reference to guidelines.
Qualifications:
Experience:
  • A minimum of four (4) years of experience in a relevant healthcare role is required, which may include clinical, coding, billing, medical records, or patient accounting.
  • A High School Diploma or equivalent, combined with five (5) years of relevant experience, may substitute for a bachelor's degree.
  • At least one (1) 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, Health Information Management/Coding, Healthcare, or Business Administration is preferred.
  • A Master's Degree in a related field is advantageous.
Licensure/Certification:
  • Possession of one of the following certifications is required: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certifications.
Equal Employment Opportunity:
Moffitt Cancer Center is an Equal Opportunity/Affirmative Action Employer. We encourage applications from individuals of diverse backgrounds and experiences, committed to our mission of diversity and excellence.

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