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The Business Systems Analyst, Revenue Integrity collects detailed data and provides analysis to assist in the development of technology plans and strategies that enhance overall performance, reduce costs, and increase efficiencies. The Business Systems Analyst, Revenue Integrity analyzes established operations, systems, methods, practices, and procedures to evaluate their effectiveness and ultimately makes recommendations for improvements. Additionally, the Business Systems Analyst, Revenue Integrity integrates people, equipment, facilities, and other resources to improve work results, operating efficiency, effectiveness, and productivity. This incumbent assists in the design, delivery, and improvement of in-house software applications, training programs, and related courseware.
Core Responsibilities:
- Reviews, analyzes and triages application issues and cases. Creates and maintains detailed support documentation of ongoing projects, tests internal application releases, and performs periodic system maintenance.
- Provides training for internal users.
- Monitors system availability, working closely with system administrators and business systems analysts.
- Recommends changes in development, maintenance, and system standards. Develops detailed action plan with goals and target dates and obtains necessary approvals.
- Maintains ongoing communication and rapport with the management team regarding project activity.
- Flowcharts existing processes versus improved flow. Prepares time and cost estimates for projects and proposals. Conducts research for best practice models and benchmarking.
- Applies industrial and management engineering techniques, such as process designs, optimization models, forecasting methodologies, and chain management principles, to improve overall systems.
- Analyzes existing flow of people, activities, and materials, employee work methods and utilization, policies and procedures, staffing levels, supervisory structure, space utilization, supply and demand optimization methods, forms, equipment, and computerized systems to design improved work systems.
- Designs systems for production and inventory control in buying, storing, handling, and processing of materials and supplies. Designs facilities, management systems, and standard operating procedures.
- Develops management control systems to aid in financial planning and cost analysis.
- Improves productivity through the application of technology and human factors. Designs supply chain management standards across the university.
- Conducts data collection to measure baseline versus improvement, before and after recommendations are implemented.
- Creates formal presentations for projects and studies, including data collected, methodology used, results obtained, recommendations for improvement, and cost and savings involved.
- Participates in continuing quality improvement activities.
- Adheres to University and unit-level policies and procedures and safeguards University assets.
DEPARTMENT SPECIFIC FUNCTIONS:
Charge Capture & Revenue Analysis
- Review clinical documentation and charge data to ensure accurate and complete billing.
- Identify trends in missed charges, denials, and underpayments.
- Conduct root cause analysis and recommend corrective actions.
System & Workflow Support
- Assist in testing and validating revenue cycle system changes and upgrades.
- Collaborate across IT and operational teams to improve charge capture workflows.
- Support implementation of automation tools and reporting dashboards.
- Provide education and feedback to clinical and operational teams on charge capture best practices.
Compliance & Documentation
- Ensure adherence to payer guidelines, coding standards, and regulatory requirements.
- Participate in internal audits and support external audit responses.
- Maintain documentation of findings, recommendations, and resolutions.
Reporting & Insights
- Generate and analyze reports on revenue integrity KPIs.
- Present findings to leadership and operational teams.
- Support data-driven decision-making and performance improvement initiatives.
This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary. MINIMUM QUALIFICATIONS:- Bachelor's degree in relevant field
- Minimum 5 years of experience in revenue cycle management (billing, coding, or financial analysis)
- Certification in Revenue Integrity required (e.g., CRCR, CHRI, CPC, CPMA).
- Epic Resolute - Certification or Proficiency preferred
- Understanding of healthcare billing, coding (CPT, ICD-10, HCPCS), charge capture, and reimbursement methodologies preferred
- Experience with major EHR and revenue cycle platforms (e.g., Epic, Cerner) preferred.
- Familiar with state-of-the-art, industry-specific technology and solutions
- Analytical thinking and attention to detail
- Demonstrated knowledge project management and change control
- Proficiency with Microsoft Office Suite programs, Excel (pivot tables), Visio, Project, PowerPoint, Word.
- Knowledge of operational healthcare, hospital and/or ambulatory and inpatient workflows and medical terminology.
- Ability to communicate ideas and problem solutions
- Ability to effectively work with people in other departments and/or outside of the enterprise.
- Excellent interpersonal skills
- Outstanding oral and written communication skills
- Works well independently or as part of a team
Any appropriate combination of relevant education, experience and/or certifications may be considered.#LI-AS1
The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.
Job Status:Full time
Employee Type:Staff