Revenue Integrity Analyst SrApply
• 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.
• 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
• (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.
• Certified Coding Specialist (CCS)
• Certified Professional Coder (CPC)
• Minnesota State Nursing License
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.