Revenue Cycle Analyst Exempt

Major Responsibilities/Essential Functions

• Monitor and analyze charge capture processes to identify missing, incorrect, or duplicate charges.
• Conduct revenue integrity audits across hospital departments including inpatient, outpatient, and ancillary services.
• Collaborate with coding, HIM, and patient financial services teams to ensure accurate coding and billing compliance.
• Analyze payer policies and regulatory requirements to ensure compliance with federal and state guidelines.
• Participate in process improvement initiatives to enhance revenue cycle efficiency and reduce revenue leakage.
• Provide education and guidance to clinical and operational staff regarding proper charge capture and documentation.
• CDM maintenance and governance, including adding, revising, and retiring charge codes.
• Charge capture review and reconciliation to ensure services are billed appropriately.
• Compliance monitoring related to CPT/HCPCS coding, payer guidelines, and regulatory requirements.
• Pricing validation and updates within the Charge Description Master.
• Coordination with departments to ensure accurate charge mapping and revenue capture.
• Charge audits and variance analysis to identify revenue leakage or compliance risks.
• Strong knowledge of medical terminology, coding guidelines, NCCI edits, and billing regulations.
• Strong communication and interpersonal skills, with the ability to work collaboratively with clinical and administrative staff.
• Able to prioritize tasks and manage time effectively in a fast-paced environment.

Job Qualifications

• Minimum Education: Bachelor’s Degree in Healthcare Administration, Health Information Management, Finance, Business Administration, or a related field.
• Preferred Education: Master’s degree in Healthcare Administration, Business Administration, or related field.
• Required Work Experience and Qualifications:
• Strong understanding of hospital revenue cycle operations including charge capture, coding, billing, and reimbursement.
• Knowledge of Medicare, Medicaid, and commercial payer regulations.
• Experience with electronic health records (EHR) and hospital billing systems.
• Advanced analytical and problem-solving skills.
• Strong proficiency in Microsoft Excel and data analysis tools.
• Possess excellent written/verbal communication skills in addition to the ability to work with minimal supervision.
• Preferred Work Experience and Qualifications:
• Proven experience in charge capture, medical billing, or a similar role within a hospital setting.
• 3-5 years' experience.
• Certified Revenue Integrity Professional (CRIP).
• Certified Coding Specialist (CCS).
• Certified Professional Coder (CPC).
• Certified Healthcare Financial Professional (CHFP).
• Required Licensure, Certification, Registration or Designation:
• Current Los Angeles County Fire Card (or must be obtained within 30 days of employment).
• Afforded Assault Response Competency (ARC) required (within 30 days of hire).
• Shift: Days
• Hours: 8 Weekly Hours: 40
• Type: Exempt FTE: 1.0