Revenue Integrity Analyst

About the role

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position starts at $47,400. Final compensation will be determined based on experience. The Revenue Integrity Analyst plays a pivotal role in ensuring financial health for acute and non-acute organization by meticulously managing the charge master, regulation code changes, work queues, charge capture, charge reconciliation, reporting, and analytical trending. This includes the identification of root cause and creation/maintenance of processes to ensure charge capture. In addition, this position is required to provide analytical insight regarding reports for charges that are not captured accurately or consistently. This position is responsible for uncovering root causes and developing a correct action plan. Recommends modifications to established practices and procedures or system functionality as needed to support Revenue Cycle and then manages implementation of those recommended changes. Job Competencies: Valuing Differences - Works effectively with individuals of diverse cultures, interpersonal styles, abilities, motivations, or backgrounds; seeks out and uses unique abilities, insights, and ideas. Considers the collective. Collaboration - Works cooperatively within teams and partners with others, both internally and externally as needed, to achieve success; focuses on the results of the team, not the achievements of one person. It's "All for One and One for All" Accountability - Accepts personal responsibility and/or consequences of failure and successes, delivering on commitments and refocusing effort when needed. Someone who is willing to step up and own it. Time Management - Effectively manages personal time and resources to ensure that work is completed efficiently. Developing Trust - Gains others' confidence by acting with integrity and following through on commitments; treats others and their ideas with respect and supports them in the face of challenges. Takes Initiative - Takes prompt action to accomplish goals and achieve results beyond what is required; is proactive and pursues relentlessly. Essential Job Functions: Charge Master Evaluates current charging processes to diagnose the root cause of any charge inefficiencies and ensures standard charge practices are implemented. Analyzes changes to coding and billing rules and regulations and using independent decision making to ensure appropriate updates to CDM and charge processes are implemented. Prepare and present quarterly and annual CPT/HCPCS changes, annual pricing updates and provide client education material and presentation. Conduct thorough research to ensure the Charge Description Master (CDM) is maintained regularly. Leads efforts of collaboration with multi-disciplinary groups responsible for monitoring and assuring the accuracy and enhancement of hospital net revenue through management of the hospital charge master. Operational Improvement Collaborates with stakeholders in revenue enhancement projects including Denial Management, APC Billing and/or other committees as needed. Provides leadership and expertise with various groups to develop new areas of review for future revenue enhancement and/or compliance initiatives. Conduct thorough analysis of billing errors and denial data to diagnose root causes. Utilizes independent decision making to execute work plans to correct identified deficiencies related to charge problems. Responsible for problem solving and resolution of complex claim edits. Stay up-to-date with industry trends, emerging technologies, and regulatory changes affecting healthcare revenue cycle management and proactively share knowledge with the team. Perform Quality Assurance on team members, as needed. Trending and analysis of