Revenue Integrity Analyst - Hybrid EPIC experience strongly preferred
Revenue Integrity Analyst - Hybrid EPIC experience strongly preferred
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1 Vacancy
Job Description
At Virtua Health we exist for one reason to better serve you. That means being here for you in all the moments that matter striving each day to connect you to the care you need. Whether thats wellness and prevention experienced specialists lifechanging care or something inbetween we are your partner in health devoted to building a healthier community.
If you live or work in South Jersey exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14000 colleagues including over 2850 skilled and compassionate doctors physician assistants and nurse practitioners equipped with the latest technologies treatments and techniques to provide exceptional care close to home. A Magnetrecognized health system ranked by U.S. News and World Report weve received multiple awards for quality safety and outstanding work environment.
In addition to five hospitals seven emergency departments seven urgent care centers and more than 280 otherlocations were committed to the wellbeing of the community. That means bringing lifechanging resources and health services directly into our communities through ourEat Well food access program telehealth home health rehabilitation mobile screenings paramedic programs and convenient online scheduling. Were also affiliated with Penn Medicine for cancer and neurosciences and the Childrens Hospital of Philadelphia for pediatrics.
Location:
PACCT 2000 Crawford PlaceEmployment Type:
EmployeeEmployment Classification:
RegularTime Type:
Full timeWork Shift:
1st Shift (United States of America)Total Weekly Hours:
40Additional Locations:
Job Information:
The position is responsible for root cause analytics along with audits to help identify opportunities issues and process improvement within the Revenue Cycle. This role supports the revenue cycle workflows charge capture workqueue and denial review processes within an Epic based EMR.
This position will help optimize Revenue Cycle by evaluating validating and trending data for presentation to all levels of the organization. Will support the Virtua Hospitals Physician Groups and Home Health.
Position Responsibilities:
Perform quantitative and financial analysis along with audits designed to identify opportunities for improvement across the full spectrum of the Revenue Cycle.
Assists in ensuring that the charge master and fee schedules are in accordance with government compliance policies and procedures as well as third party payor needs. Review identify and analyze necessary CPT changes related to quarterly and annual AMA CPT updates and regulatory changes by timelines set. Works with revenue producing departments to ensure the ongoing coordinated consistency of the charge master and fee schedules including accurate descriptions coding additions deletions pricing and any other changes. Conduct analytical reviews determine net revenue effect of proposed charge master and fee schedule changes. Perform internal billing audits to ensure correcting coding/billing regulatory compliance and charge capture accuracy.
Incumbent must develop close working relationships with management and staff in Revenue Integrity Finance Information Technology and Revenue and Clinical Operations allowing them to perform deepdive analysis and reviews assisting with the identification of trends solutions and potential corrective action steps. Will work both independently and have a high level of selfdirected work efforts as well as be an integral part of the Revenue Integrity Team. Revenue Cycle will include areas from Hospital Physician and Home Health.
Monitor and assists with review of revenue cycle workqueues in Epic. Perform analysis to identify issues trending root cause and action plan development with workqueue issues.
Assist in strategic pricing process to optimize reimbursement within budget guidelines. Participate in ongoing coordination and resolution of revenue issues as they arise. Assists in troubleshooting and resolving issues related to the patient revenue cycle and assists in development and recommendations.
Provide guidance and communication and collaborate with Revenue Integrity Team Clinical Operations and IT to help ensure workqueue rules are accurate and updated based on annual and quarterly coding changes.
Assist with Epic performance reporting including assisting with Revenue & Usage Enterprise Charge Reconciliation and Volume Reports. Workqueue and reporting will include areas from Hospital Physician and Home Health.
Serve as resource to Patient Financial Services staff for reporting problems and denials on individual claims. Assist in researching coding issues provide guidance and recommend solution to account representative.
Analyze billing errors and denial data to identify root cause of issues. Work with Revenue Integrity Team Clinical Operations and Patient Financial Services staff to implement corrective actions to ensure compliant charges prevent future rejections/denials and accurate and reimbursement. Claim issues and denials will include areas from Hospital Physician and Home Health.
Lead and participate in projects related to Revenue Cycle initiatives. Participate in ongoing coordination and resolution of revenue issues as they arise. Provide input to Director and Manager for annual Revenue Integrity planning process. Assist with additional projects as needed for Hospital Physician and Home Health.
Position Qualifications Required:
Required Experience:
3 to 5 years experience within a large hospital or integrated healthcare delivery system.
- Ability to work collaboratively across disciplines and business lines.
- Exceptional oral/written communication skills and highly customerfocused.
- Excellent interpersonal and presentation skills.
- Able to communicate with many various customers.
- Ability to prioritize plan and execute.
- Excellent critical thinking analytical skills.
Required Education:
Bachelor Degree in Accounting Finance Healthcare preferred
Training / Certification / Licensure:
EPIC Revenue Integrity Hospital Billing Physician Billing Certification preferred
Required Experience:
IC
Employment Type
Full-Time
