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Revenue Cycle Integrity Analyst

2 months ago

Irvine, California, United States University Of California Irvine Full time

Overview:

Position Summary:

The University of California, Irvine is a distinguished institution known for its commitment to academic and healthcare excellence. Our team comprises a diverse group of professionals, researchers, and medical experts dedicated to fostering innovation and collaboration. This is an opportunity to advance your career within a supportive and dynamic environment.

Reporting directly to the Assistant Director of Revenue Integrity, the Revenue Integrity Analyst will engage in data gathering, report generation, and in-depth financial analysis related to hospital operations. This role is crucial in supporting the internal functions of Revenue Integrity and the overall revenue cycle management of the organization. Responsibilities include monitoring charge capture processes, managing system interfaces, assisting with charge automation projects, and collaborating with revenue cycle partners on system enhancements. The analyst will also retrieve data for both standard and ad hoc reporting as required. The analysis will encompass trends, benchmarking, functional workflows, and performance metrics aimed at identifying areas for improvement within the revenue cycle. The incumbent will serve as the primary contact for all institutional revenue generation activities related to diagnostic and therapeutic services.

Key Responsibilities:

  • Develop, review, and recommend improvements to system policies and procedures to ensure optimal utilization. (10%)
  • Create comprehensive analytical reports and summaries. Collect and organize relevant data to address assigned challenges, ensuring the provision of accurate and timely information to assist leadership in identifying improvement opportunities. (30%)
  • Conduct extensive analyses, including benchmarking and performance improvement assessments for revenue integrity functions. Identify corrective actions as necessary and provide detailed financial analysis of revenue cycle performance indicators with recommendations for enhancement. (30%)
  • Monitor daily charge processing and system interfaces, addressing issues as they arise. Act as a liaison among staff, department managers, and revenue cycle teams. (20%)
  • Contribute to project plans for system upgrades and programming enhancements, outlining objectives, scope, resources, timelines, and expected outcomes. Collaborate with project teams to share information and resolve project-related challenges. (10%)

Qualifications:

Required Qualifications:

  • Ability to effectively collaborate with all levels of healthcare personnel, including directors and physicians.
  • Strong written and verbal communication skills in English.
  • Experience with hospital billing systems and familiarity with third-party billing requirements, typically acquired through five years of relevant experience.
  • Proficiency in transforming master files into reports for departmental use and in technical report writing.
  • Advanced computer skills, particularly in Microsoft Access and Excel.
  • In-depth knowledge of split fee billing and outpatient charging practices.
  • Relevant coding certification (CPC-H, CPC, or equivalent).
  • Understanding of ICD-10 and CPT coding systems.
  • Ability to interpret governmental and commercial payer regulations and develop recommendations accordingly.
  • Familiarity with HIPAA regulations.

Preferred Qualifications:

  • Knowledge of Structured Query Language (SQL).
  • Experience with data visualization tools such as Tableau.
  • Bachelor's Degree in Business, Finance, or a related field.

Conditions of Employment:

The University of California, Irvine is committed to providing a safe and healthy environment for its community. All candidates who accept an employment offer must comply with specific conditions of employment.

Closing Statement:

The University of California, Irvine is an Equal Opportunity/Affirmative Action Employer. We value diversity and are committed to creating an inclusive environment for all employees.