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Revenue Integrity Analyst Sr

Job ID 18-1291 Date posted 07/13/2018 Employment Type Full Time (Regular) Shift Days Shift Length 8 Hours Weekend Requirement None Hours Per Pay Period 80 Department Managed Care Admin Location Robbinsdale, Minnesota
DescriptionThe Senior Revenue Integrity Analyst educates and trains team members across the North Memorial Health organization to optimally utilize charge tools and charge entry systems. This role is critical to developing and sustaining charging competence among operations and revenue cycle team members. The Senior Revenue Integrity Analyst supports and promotes revenue integrity initiatives related to charge capture throughout the health system.

Accountabilities:
• Educates operational departments on charge capture processes, fostering department responsibility to understand and be accountable for capturing charges.
• Trains stakeholders in regulatory and payor updates impacting the charge capture process.
• Ensures the sustainability and integrity of charge capture initiatives through consistent communication of results and development of training materials, as necessary.
• Researches Medicare, CPT/HCPCS coding, and payor requirements for maximizing reimbursement and maintaining compliant practices related to charge capture.
• Coordinates with IT, CDM, CDI, Coding, Business Office, Finance, operational departments, and other support staff in identifying workflow best practices to maximize the charge capture process.
• Engages with departments/stakeholders to implement process improvement initiatives related to revenue enhancement opportunities.
• Assesses site or department specific procedures to ensure revenue integrity and compliance with charge capture processes.
• Assists and coordinates analysis of charts and performs focus reviews to support charge capture performance improvement.
• Summarizes review findings and preliminary recommendations.
• Assists departments in developing and maintaining charge capture reconciliation processes.
• Analyzes charges to identify trends of missing or misdirect charges to resolve charge capture related issues.
• Collaborates with Business Office and departments related to late charge entry process improvements to ensure accurate and efficient charging.
• Collaborates with Business Office and departments to analyze denials and claims on hold due to charge errors; provides education to mitigate errors.
• Facilitates the resolution of charge errors to assure appropriate and compliant revenue.
• Responsible for understanding the accuracy and efficiency of technology systems and workflows for charging activities.
• Reviews charging activities of each department to ensure that all activities are accounted for in the charge master and priced appropriately.
RequirementsEducation
• Bachelor's degree in health administration, health information systems, business or related field required or equivalent relevant experience and certification (RHIT, CCS, CPC)
• Epic certification preferred

Experience
• (5) years of experience in healthcare, specifically on revenue cycle operations, charge master, coding, finance, auditing or related experience.
• Familiarity with billing regulations and CPT/HCPCS codes/coding rules required
• Eight (8) years of related experience may be acceptable in lieu of a Bachelor's degree

Knowledge, Skills and Abilities
• Possess excellent analytical, organizational, verbal and written communication skills and be professional in both appearance and approach.
• Comprehensive understanding of Federal, State and Local coding guidelines and payment methodologies.
• Knowledge of hospital revenue cycle operations, hospital charge masters, as well as hospital department charge capture and charge reconciliation.
• Understanding of Regulatory External Audits.
• Proficient and functional knowledge billing, documentation, and charges in an EMR System (EPIC) required.
• Ability to demonstrate continuous personal development and improvement.
License Requirement• Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT)
NMHC Preferred

• Certified Coding Specialist (CCS)
NMHC Preferred

• Certified Professional Coder (CPC)
NMHC Preferred

• Minnesota State Nursing License
NMHC Preferred

At North Memorial Health, we’re on a mission to change healthcare. We’re delivering unmatched customer service and empowering our customers throughout Minnesota and Western Wisconsin to achieve their best health. North Memorial Health is a leader in delivering advanced medical care from Emergency, Urgent Care, Specialty Programs and Services, Primary Clinics, Ambulance and Air Medical Transportation.


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