Revenue Integrity Analyst Full Time Day
Revenue Integrity Analyst Full Time Day
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Supporting specific service lines this position is responsible for ensuring the integrity and maintenance of the multihospital and multispecialty physician practice charge description master (CDM) within Cerner. Supports appropriate coding revenue capture and reimbursement.
This position supports Revenue Integritys Mission of promoting complete accurate compliant and timely revenue capture by serving as the bridge between clinical operations finance information technology and revenue cycle.
Reporting to the Director of Revenue Integrity this position is responsible for performing charge master maintenance researching new clinical items and services for appropriate billing and coding working with departments to resolve suspended charges and other charge issues prior to claim submission facilitating regular revenue operations meetings with assigned departments and providing basic analytical support to internal customers.
Education
Bachelors degree preferred or equivalent combination of education training and experience.
Certification Registration and Licensure
AHIMA or AAPC medical coding certification (e.g. CPC COC CCSP CCS) within two years of hire. Alternate certifications will be considered on a casebycase basis (e.g. RHIA).
Experience
Minimum of three years experience in healthcare revenue integrity managed care contracting billing auditing charge master coding or compliance in an acute care hospital.
Must have at least one year experience working with reimbursement methodologies (i.e. IPPS OPPS MPFS managed care).
Extensive knowledge of CPT HCPCS and Revenue Codes required. Knowledge of revenue cycle processes and hospital/medical billing required.
Must have familiarity with government and managed care reimbursement methodologies to include IPPS OPPS and fee schedules. Must have the ability to research payer requirements and policies. Knowledge of NCCI edits and Medicare LCDs/NCDs required. Ability to review analyze and interpret billing guidelines and state and federal regulations.
Experience with Cerner charge services applications preferred.
Must demonstrate effective problem solving skills. Excellent communication skills (written and verbal) required. Must have demonstrated ability to successfully collaborate with department leadership and staff.
Must have demonstrated ability to work independently under minimal supervision and possess effective time management skills to permit successful handling of multiple projects and tasks. Requires the ability to communicate effectively with individuals at all levels within the organization including leadership.
At minimum intermediate level of proficiency with Windows based software including but not limited to Microsoft Word Excel and PowerPoint required.
Responsibilities
Manage charge master maintenance for assigned clinical service line(s). Assist with and participate in annual charge master review price increase codeset update and other CDM projects.
Research charging reimbursement and coverage requirements for procedures and services as requested. Assist stakeholders with charge reporting and reconciliation and provide training on these tasks when necessary.
Develop and maintain an expert understanding of charge capture workflow for assigned service line(s). Troubleshoot charge posting issues. Identify charging opportunities. Manage assigned work queues and suspended charges.
Facilitate revenue operations meetings with assigned clinical service lines. Serve as the primary point of contact for all revenuerelated questions from service line leadership and other stakeholders
Performs other duties as assigned.
Concord Hospital is an Equal Employment Opportunity employer. It is our policy to provide equal opportunity to all employees and applicants and to prohibit any discrimination because of race color religion sex sexual orientation gender gender identity national origin age marital status genetic information disability or protected veteran status.
Know Your Rights: Workplace Discrimination is Illegal
Applicants to and employees of this company are protected under federal law from discrimination on several bases. Follow the link above to find out more.
If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process you may contact Human Resources at.
Physical and Work Requirements
The physical demands and characteristics of the work environment described here are representative of those that will be encountered by an employee to successfully perform the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The Dictionary of Occupational Titles Material Handling Classification is SEDENTARY. The employee must regularly lift carry or push/pull less than 10 pounds frequently lift carry or push/pull less than 10 pounds and occasionally lift carry or push/pull up to 10 pounds.
The employee is frequently required to do repetitive motion hear perform activities that require fine motor skills reach sit speak and walk. The employee is occasionally required to bend drive squat and stand.
Specific vision abilities required by this job include color vision depth perception far vision near vision and peripheral vision.
The employee is occasionally exposed to electrical hazards shock.
The noise level in the work environment is usually quiet.
Required Experience:
IC
Employment Type
Full-Time
