Revenue Integrity Analyst
Job
Summary:
The Revenue Integrity Analyst working under the general direction of the Executive Director, Revenue Cycle, is responsible for activities which assist the hospital with processes for complete and accurate capture of documentation and charges for the facility outpatient services rendered, provides analysis/review of chargemaster, charge capture and charge reconciliation and while exhibiting innovation good judgment as well as a thorough knowledge of ethical and legal billing procedures for hospital billing.
The Revenue Integrity Analyst assists clinical areas to effectively and accurately document services and understand relationship of documentation, medical necessity, coding and charging for all services provided, in addition to providing education and training of staff on clinical documentation, coding and charging for facility outpatient services in accordance with policies and procedures, while observing confidentiality in all matters.
The Revenue Integrity Analyst has a clear understanding of chargemaster related impacts to the hospital, revenue cycle operations and overall financial performance.
Qualifications:
Education:
Bachelor's degree in Nursing, Finance, Healthcare Administration or Business Administration Minimum five years health care experience with three years of chargemaster, billing or coding in lieu of degree.
Certification/Licensure:
Certified coder a plus.
Software/Hardware:
Proficient in using Microsoft Excel, PowerPoint, and Word.
Experience:
3 years of healthcare knowledge as a clinical caregiver/manager, coding specialist or revenue cycle management.
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.
Experience using Meditech preferred.
Licensure and/or Certification:
AHIMA or AAPC preferred.
Skills:
Understanding of hospital-based outpatient charging, coding and/or revenue capture functions Ability to organize and work with minimum supervision at a high level of motivation and initiative while being entrepreneurial, creative and results oriented and must possess proactive orientation with a willingness to take managed risks.
Advanced proficiency with Microsoft Office applications.
Knowledge Meditech preferred.
Knowledge of electronic medical records required.
Excellent organizational skills, detail oriented with strong ability to multi-task required.
Familiarity with medical terminology.
Effective verbal and written communication skills and good listening skills with the ability to interpret end user's needs.
Ability to read, write and communicate in English.
Excellent customer service skills.
Ability to maintain confidential information required.
Computer skills required.
Experience with chargemaster maintenance or proficient knowledge of chargemaster components (CPT, HCPCs, Revenue Codes) Knowledge of CPT-HCPCS, third party reimbursement methodologies, and revenue cycle process Expert knowledge of inpatient and outpatient billing requirements, coding guidelines and CMS Medicare reimbursement methodology Excellent communication and interpersonal skills with the ability to effectively interpret, communicate, and educate others.
Strong quantitative, analytical, and organizational skills Ability to respond to complex inquiries in a professional and efficient manner.
Recommended Skills Active Listening Analytical Attention To Detail Business Administration Clinical Works Confidentiality Estimated Salary: $20 to $28 per hour based on qualifications.
Summary:
The Revenue Integrity Analyst working under the general direction of the Executive Director, Revenue Cycle, is responsible for activities which assist the hospital with processes for complete and accurate capture of documentation and charges for the facility outpatient services rendered, provides analysis/review of chargemaster, charge capture and charge reconciliation and while exhibiting innovation good judgment as well as a thorough knowledge of ethical and legal billing procedures for hospital billing.
The Revenue Integrity Analyst assists clinical areas to effectively and accurately document services and understand relationship of documentation, medical necessity, coding and charging for all services provided, in addition to providing education and training of staff on clinical documentation, coding and charging for facility outpatient services in accordance with policies and procedures, while observing confidentiality in all matters.
The Revenue Integrity Analyst has a clear understanding of chargemaster related impacts to the hospital, revenue cycle operations and overall financial performance.
Qualifications:
Education:
Bachelor's degree in Nursing, Finance, Healthcare Administration or Business Administration Minimum five years health care experience with three years of chargemaster, billing or coding in lieu of degree.
Certification/Licensure:
Certified coder a plus.
Software/Hardware:
Proficient in using Microsoft Excel, PowerPoint, and Word.
Experience:
3 years of healthcare knowledge as a clinical caregiver/manager, coding specialist or revenue cycle management.
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.
Experience using Meditech preferred.
Licensure and/or Certification:
AHIMA or AAPC preferred.
Skills:
Understanding of hospital-based outpatient charging, coding and/or revenue capture functions Ability to organize and work with minimum supervision at a high level of motivation and initiative while being entrepreneurial, creative and results oriented and must possess proactive orientation with a willingness to take managed risks.
Advanced proficiency with Microsoft Office applications.
Knowledge Meditech preferred.
Knowledge of electronic medical records required.
Excellent organizational skills, detail oriented with strong ability to multi-task required.
Familiarity with medical terminology.
Effective verbal and written communication skills and good listening skills with the ability to interpret end user's needs.
Ability to read, write and communicate in English.
Excellent customer service skills.
Ability to maintain confidential information required.
Computer skills required.
Experience with chargemaster maintenance or proficient knowledge of chargemaster components (CPT, HCPCs, Revenue Codes) Knowledge of CPT-HCPCS, third party reimbursement methodologies, and revenue cycle process Expert knowledge of inpatient and outpatient billing requirements, coding guidelines and CMS Medicare reimbursement methodology Excellent communication and interpersonal skills with the ability to effectively interpret, communicate, and educate others.
Strong quantitative, analytical, and organizational skills Ability to respond to complex inquiries in a professional and efficient manner.
Recommended Skills Active Listening Analytical Attention To Detail Business Administration Clinical Works Confidentiality Estimated Salary: $20 to $28 per hour based on qualifications.
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