Senior Analyst, Rev Integrity

The Senior Analyst Revenue Integrity reflects the mission vision and values of Northwestern Medicine (NM) adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.

The Senior Revenue Integrity Analyst will support the Clinical Department and revenue cycle and perform charge capture analysis including annual price increase analysis. The Senior Revenue Integrity Analyst will be responsible for helping maintain the charge master to ensure compliance accuracy and consistency for Northwestern Medicine. The Senior Revenue Integrity Analyst will prepare analysis and support for management and the Clinical Departments.

Responsibilities:

• Perform daily maintenance and quarterly audits of the EAP.
• Prepare necessary files for the EAP database of required department builds.
• Proactively identify charge capture opportunities in all revenue producing departments.
• Research and interpret billing and coding regulations communicate to impacted areas and apply changes that affect policy financial charge capture patient care billing and coding operations.
• Lead quarterly audits on the charge master data elements.
• Review departmental front-end charge capture tools for accuracy.
• Leads complex audits and prepares methodology for annual pricing changes and/or annual coding changes.
• Consistently delivers concrete relevant results. Displays qualities of resiliency and resourcefulness while thinking strategically and practically when problem addition to results orientation displays business knowledge speed and decisiveness and project management.
• Troubleshoot complex account errors and provides education for resolution to Revenue Manager(s).
• Resolve and answers questions related to charge capture and complex regulatory billing issues. (e.g. Provider-Based status rules OPPS CCI MUE).
• Liaison with Revenue Cycle IT and clinical departments to link EPIC and charge master.
• Research compile and analyze financial data while organizing and maintaining database files for financial modeling.
• Mentors and supports members of Revenue Integrity Team as an informal leader. 
• Lead efforts to assess modify and/or develop and implement more timely and consistent processes/systems to increase efficiency accuracy and meaningfulness of information.
• Demonstrates knowledge in computer applications such as knowledge in databases spreadsheets and word processing applications in a high complexity environment.
• Maintain professional and technical knowledge by attending educational workshops reviewing professional publications establishing personal networks adopting and implementing industry best practices and participating in professional societies.
• Supports the finance operations and revenue cycle teams through special projects.
• Protect operations by keeping financial and patient information confidential.
• Supports the finance operation of Northwestern Medicine.

Qualifications :

Required:

• Bachelors Degree in Business or related field or 10 years of equivalent experience with progressive advancement.
• Strong communication collaboration and analytical skills
• Proficiency with  Microsoft office suite
• 5 years in revenue cycle or revenue integrity role
• Requires critical thinking decisive judgment high attention to detail and ability to work with minimal supervision
• Advanced understanding of CPT HCPCS ICD-10 and third party billing requirements
• Extensive knowledge and experience with Medicare/Medicaid regulations

Preferred:

• EPIC Certification (Resolute Charge Capture)
• EPIC Certification (Clarity Report Data)
• Masters degree in Healthcare Management Business MIS Data Analytics or related field
• Beginner to Moderate knowledge of SQL and relational databases
• RHIA preferred or related health care credential (e.g. Radiology technician RN)

Additional Information :

Northwestern Medicine is an equal opportunity employer (disability VETS) and does not discriminate in hiring or employment on the basis of age sex race color religion national origin gender identity veteran status disability sexual orientation or any other protected status.

Background Check

Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and at times internal transfers. If you are offered a position with us you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check.  Results are evaluated on a case-by-case basis and we follow all local state and federal laws including the Illinois Health Care Worker Background Check Act.

Artificial Intelligence Disclosure

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position however all employment decisions will be made by a person. 

Benefits

We offer a wide range of benefits that provide employees with tools and resources to improve their physical emotional and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.

Sign-on Bonus Eligibility: Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family. 

Remote Work :

No

Employment Type :

Full-time