Revenue Charge Integrity Analyst

Job Summary

The Charge Integrity Analyst plays an essential role in Michigan Medicine's Revenue Cycle. Analysts maintain charge and charge-related functionality, provide system and departmental support, and help to ensure the integrity and accuracy of patient accounts.

Responsibilities

• Ensure that the Charge Master is built and maintained in accordance with hospital policies, AMA guidelines, Federal and State law, National Uniform Billing Committee standards, CMS and other regulatory and payor mandated charge capture guidelines, including revenue code, CPT, HCPCS, and modifiers.
• Maintain Coding Certification including staying current on articles, newsletters, memos and attend seminars to successfully oversee the Charge Master and ensure its proper use.
• Audit, utilize, and maintain Charge Master data in FinThrive and in the Epic EAP master file.
• Set hospital rates following department policy, using standardized pricing algorithms, available benchmarking and other rate setting tools.
• Work with other Charge Integrity team members and MiChart CORE team as assigned to maintain a variety of MiChart files and databases.
• Maintain and support all charging methods including: Charge Capture Preference Lists, Bedside Procedure SmartForms, Clinic Performed Orders/Procedures, LOS, SmartSets and other charge capture tools.
• Support departmental modules and workflows that interface/support charge capture.
• Maintain organized files of all critical correspondence, charge and fee schedule changes.
• Participate in the design, build, and testing of new and existing rules that track and identify potential charge errors.
• Assist in developing and establishing new departments by creating charging workflows, ensuring correct charge capture and reconciliation support.
• Work with Clinical Departments, Revenue Cycle peers, and other MM teams to ensure proper charge generation from clinical systems.
• Provide support as needed to Finance and other Revenue Cycle departments.
• Work MiChart Workqueues. Monitor WQs for spikes and assist with identifying root causes. Identify areas of improvement and propose solutions to increase efficiency.
• Act as liaison between Billing and Clinical Departments to investigate and resolve issues.
• Participate in research, build, test script development, testing, training and go-live support of periodic MiChart Upgrades, new module implementations, system optimizations and other organizational projects.
• Support Revenue Cycle initiatives by creating reports, analyzing data, and creating/presenting SBARs as necessary.

Required Qualifications

• Associate's degree in Business Administration, Healthcare Administration, Health Information Management, Health Information Technology or equivalent combination of education and work experience.
• Experience with reimbursement, billing, medical coding and compliance related to a large medical institution.
• Experience as a Certified Coder, Charge Master Administrator, Revenue Integrity Specialist, Epic Analyst, Senior Biller, Medical Compliance Officer or equivalent title.
• Exceptionally strong problem solving, analytical and organizational skills.
• Ability to research root cause, recommend solutions and support improvements.
• Extensive experience with Electronic Health Record, clinical and billing workflows (such as Epic or Cerner).
• Extensive experience with MS Office tools with strong emphasis on advanced Excel knowledge.
• Self-motivated and detail oriented with the ability to work independently.
• Excellent communication with the ability to articulate both written and verbal communication(s).
• Strong customer service focus.
• Great attendance record.

Desired Qualifications

• Bachelor degree in Business Administration, Healthcare Administration, Health Information Management, Health Information Technology or equivalent combination of education and experience.
• RHIT, CPC certification or equivalent combination of education and experience.
• Experience with University systems including, Epic EHR (MiChart), Tableau, Finance BI, and SlicerDicer.
• Knowledge of payer websites, compliance tools, and billing resources.
• Proficiency in Microsoft PowerPoint, Access, Visio.
• Hospital Billing experience within the last 5 years.
• Knowledge of University Health System policies, procedures and regulations.
• Knowledge of or experience in the delivery of patient care and front-end workflows.
• Experience performing financial and billing data reviews, claim and medical record audits, documentation analysis, and identifying areas of financial risk.
• Experience interpreting and applying CMS and other payer guidelines and regulations.