Revenue Integrity Charge Analyst

Job Summary

The Revenue Integrity Charge Review Analyst is responsible for determining and identifying variations in daily total charges across all hospital revenue generating departments. This role involves monitoring daily ancillary charge reports, reviewing denial trends, serving as a liaison between facilities administration, shared services center, and ancillary department directors, conducting reviews of charging, coding, and clinical documentation, and collaborating with corporate revenue integrity leadership.

Qualifications

• Associate Degree or above; or healthcare license/certification required.
• Minimum 1 year directly related healthcare experience or coding experience required.
• Knowledge of CPT/HCPCS codes or experience in charging or performing charging validation reviews preferred.
• Healthcare certification/licensure such as RHIT, CCS, CCP, CPC, or other recognized AHIMA certified coding credential, LPN, LVN, RT, PT, etc., can be accepted lieu of degree with work experience.

Benefits

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services.
• Wellbeing support, including free counseling and referral services.
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence.
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling.

Responsibilities

• Conduct reviews of charging, coding, and clinical documentation, collaborating with Corporate Revenue Integrity Leadership during Meditech Expanse implementation.
• Maintains constant communication with Facility Departments during Meditech Expanse implementation to address identified charging issues, both prior to and after go-live.
• This role ensures the Facility CFO is regularly updated on the progress of charging activities.
• Performs detailed charge audits by verifying billing data against clinical documentation, making necessary corrections in Patient Accounting.
• Bases on audit findings, presents recommendations to Corporate and SSC Revenue Integrity Leadership, as well as facility ancillary department directors, to enhance documentation accuracy, charging workflows, and overall compliance.
• Collaborates with Facility Department Directors in developing chargemaster and charging practices for new service lines or procedures, following approved standardization guidelines.
• Maintains constant monitoring of charging practices across all facilities through charge reviews, remedial training, and education.
• Acts as Chargemaster liaison for clinical departments to facilitate education on appropriate charging of CPT codes and Revenue Codes.
• Collaborates with Ancillary Departments to resolve issues and coordinate necessary updates (activation, deactivation, or modification).
• Reviews HCA regulatory communications, applicable CMS transmittals, and Local Coverage Determinations (LCDs), assesses their impact on Revenue Integrity procedures, and implements necessary changes.
• Maintains up-to-date billing knowledge through webcasts and conference calls, ensuring continuous education.

Requirements

• Possess working knowledge of Medicare guidance, inpatient/outpatient status, and observation requirements.
• Knowledge of Revenue Cycle Pro, 3M Coding systems, and 3M Coding Resources.
• Participates in charge optimization projects and supports the Corporate Revenue Integrity team on special projects, charge reviews, and patient audits as needed.

Skills

• Working knowledge of Medicare guidance, inpatient/outpatient status, and observation requirements.
• Knowledge of Revenue Cycle Pro, 3M Coding systems, and 3M Coding Resources.

Pay

Details about pay are not specified in the job posting.

Schedule

Details about schedule are not specified in the job posting.