Senior Revenue Integrity Analyst

About the role

The senior revenue integrity analyst is responsible for planning and oversight of the revenue integrity analysts’ performance of essential department accountabilities, including reporting to department leadership about goal status.

Responsibilities

• Maintain work queues and understand, apply yearly regulatory changes.
• Maintain the chargemaster and prevent revenue leakage.
• Facilitate accurate, compliant billing of patient accounts.
• Assist revenue integrity analysts with task completion and queue management.
• Create, edit, delete and research various CDM requests for all hospital departments for both hospital and professional billing.
• Establish and enforce the hospital’s pricing, coding, and regulatory changes.
• Aid in hospital decision making related to chargemaster requests.
• Provide operational analytical support with regards to reimbursement, charge lag, revenue trends, and other revenue related items.
• Collaborate with Health Information Management, Information Systems, Billing, Finance and Operations.

Requirements

• Bachelor’s degree in Health Information Management, Finance or related field required, Masters preferred.
• 6-10 years of revenue integrity, analyst, etc. experience in healthcare.
• Experience with EPIC electronic health record.
• EPIC CDM/Revenue Integrity (HB and PB) certification within 6 months of employment required.
• Ability to research CPT and regulatory requirements.
• Experience with CPT and HCPCS codes and interpreting CPT guidance.
• Proficiency in healthcare billing, CMS Medicare and Medicaid reimbursement methodologies.
• Proficiency in Microsoft Office Tools (Outlook, Excel).

Preferred Qualifications/skills

• Trisus (Craneware) chargemaster experience.
• Strata experience.
• Registered Health Information Administrator (RHIA) Certification.