Revenue Integrity Analyst

This position is onsite in Las Vegas, NV and is not eligible for remote work.

About the role

Maintains the Chargemaster fee schedule in accordance with established coding practices and governmental regulatory requirements. Conducts quality control audits and reviews charge capture clinical workflows for missed revenue opportunities. Creates action plans for capturing missed revenue. Identifies edits in patient management/billing software that impact billing accuracy. Ensures CPT, HCPCS, and revenue codes are accurate and compliant with all charging and billing guidelines. Serves as a liaison between Revenue Cycle and clinical operations and information technology regarding revenue, compliance, and clinical workflow build.

Requirements

• Graduation from an accredited school of nursing or equivalent to a Bachelor’s Degree in healthcare, finance, or a closely related field
• Three (3) years of experience in reviewing hospital charge capture, medical records, clinical charts, regulatory and policy compliance, and/or claims auditing
• Valid state license as a Registered Nurse or certification in one of the following:
  • Certified Professional Coder (CPC)
  • Certified Coding Specialist – Physician based (CCS-P)
  • Certification in Healthcare Revenue Integrity (CHRI)
  Note: If not already certified, must obtain certificate within one (1) year of employment; failure to obtain and/or maintain licensure will result in termination.
• 1–2 years of outpatient procedural coding experience
• 2 years of maintaining CDM
• Experience using Epic
• Experience in Revenue Cycle Management
• Experience in Revenue Integrity
• Knowledge of CPT, HCPCS, and Revenue Codes

Benefits

• Employer-paid pension plan (Nevada PERS)
• Competitive salary & benefits package