Revenue Integrity Analyst

We’re looking for a Revenue Integrity Analyst, someone who’s ready to grow with our company. In this position you will lead, manage, and/or participate in all Revenue Integrity related projects as assigned by the Director. This incumbent is also responsible for leading and/or supervising initiatives to improve or optimize efficiency while serving both internal and external customers.

Think you’ve got what it takes?

Job Duties & Responsibilities

• Edit and exception resolution. Resolves or coordinates the resolution of charge session edits including DNB, revenue guardian edits, denials, and audits on a timely basis.
• Apply coding, payer and charge capture conventions to compliantly resolve edits
• Identifies opportunities for capturing additional revenue in accordance with payer guidelines
• Keeps edits and exceptions within targets as assigned by leadership
• Coordinates efforts for resolution with all Revenue Cycle Departments as appropriate
• Communicates with clinical departments, when needed, to assist in edit resolution
• Evaluates edits to determine potential opportunities for automated resolution
• Maintains high productivity and quality with minimal supervision over assigned work queues
• Develops measures to track, trend, and monitor charge sessions and account resolutions, including audits and denials.
• Provides consistent and clear feedback to the Revenue Integrity Team, Revenue Cycle Counterparts, and Hospital Operations and Providers
• Track and trend defense audits
• Identify and monitor departments with charge capture and denial issues and develop processes for improvement.
• Serve as the contact and advocate to assigned Service Line leadership for all revenue cycle processes and workflows.

Skills & Requirements

• Required High School Diploma or GED HSD must be accompanied by a certification or bachelor's degree  
• Required one of the following certifications:
  • CHRI - Certified Healthcare Revenue Integrity Professional by the National Association of Healthcare Revenue Integrity (NAHRI)  
  • CRCR - Certified Revenue Cycle Representative by the Healthcare Financial Management Association (HFMA)  
  • CHFP - Certified Healthcare Financial Professional by the Healthcare Financial Management Association (HFMA)  
  • CSAF - Certified Specialist Accounting & Finance by the Healthcare Financial Management Association (HFMA)  
  • CPC - Cert-Cert Professional Coder by the American Academy of Professional Coders (AAPC)  
  • RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA)  
  • RHIT - Cert-Reg Health Inform. TECH by the American Health Information Management Association (AHIMA)  
  • CCS - Cert-Cert Coding Specialist by the American Health Information Management Association (AHIMA)  
  • CCS-P - Cert-CCS-P Physician Based by the American Health Information Management Association (AHIMA)  
  • COC - Certified Outpatient Coder by the American Academy of Professional Coders (AAPC)  
• Required 4 years Revenue Cycle experience, including but not limited to Revenue Integrity, Billing, Coding, Denials, Follow-Up, Patient Accounts, and/or Refunds experience

**Hospital Billing and Coding Background highly desired