Salary Range
$32.56 - $50.84
Summary
This position supports Revenue Integrity's mission to create a multidisciplinary team that strengthens the interface between clinical departments and the charge improvement process. The goal is to achieve operational efficiency, complete regulatory compliance, and total reimbursement. Under the direction of the Manager of Revenue Integrity, the Revenue Integrity Analyst II is a key member of a high-profile team dedicated to enhancing revenue outcomes. This role involves a comprehensive analysis of clinical and financial processes, functions, and interdependencies, spanning from patient care delivery to final bill generation.
Position Reports To: Revenue Integrity Manager
Essential Functions
- Assist in resolving claim edits that hold patient claims from billing by reviewing medical records and other applicable documentation.
- Identify, report, and resolve potential or actual revenue/charge-related issues.
- Assist with account fixes and charge reconciliation for other departments based on clinical documentation.
- Basic understanding of CDM processes and contracting.
- Monitor Epic Revenue Integrity Dashboards.
- Perform analysis, problem resolution, compose rules, and leverage Epic IT to complete system work.
- Interact professionally with coworkers and customers, both in person and in writing.
- Perform medium to high complexity testing of new and modified Epic builds at the direction of Epic IT.
- Work with Revenue Cycle to identify and fix errors based on ICD/CPT coding guidelines and National Correct Coding Initiative edits and other industry-published rules and regulations.
- Confidently take on new tasks and projects, even when additional training is required.
- Demonstrate strong critical thinking, judgment, and analytical skills in problem-solving and decision-making.
- Communicate effectively and professionally in person, in writing, and through various communication channels.
- Support improvement initiatives as directed by leadership. Participates in moderately complex projects related to Revenue Integrity.
- Perform quality work within deadlines and Key Performance Indicators (KPI) with limited supervision.
- Performs other duties as assigned.
Demonstrate Standards of Behavior and adhere to the Code of Conduct in all aspects of job performance at all times.
Qualifications
Required:
- High School Diploma.
- 3-5 years in Revenue Cycle (or equivalent combination of higher education and experience) with focus in one or more of the following areas: Coding, Follow-up/Denials, Prebill, Patient Access/Registration/Authorizations, Patient Financial Services/Payments/Refunds, Revenue Integrity Education.
- Applicable certification through AHIMA (CCA, RHIA, RHIT), AAPC (CPC, COC, CPB) OR Epic certification.
- Knowledge in clinical and financial processes within healthcare.
- Proficiency in Microsoft Office Suite.
- Strong interpersonal communication, analytic, problem solving, and critical thinking skills.
- Ability to communicate professionally in person and in writing.
- Reporting skills (i.e. SlicerDicer).
Desired:
- Associate's Degree or specific industry related degree.
- Charge Description Master experience. Comprehensive understanding of reimbursement theories to include DRG, OPPS, HCC and managed care.
- Additional Epic Certification(s) or Builder Tracks.
- AI in Revenue Cycle.
Physical/Sensory Demands
O = Occasional, represents 1 to 25% or up to 30 minutes in a 2 hour workday.
F = Frequent, represents 26 to 50% or up to 1 hour of a 2 hour workday.
C = Continuous, represents 51% to 100% or up to 2 hours of a 2 hour workday.
Physical/Sensory Demands For This Position:- Walking - O
- Sitting/Standing - C
- Reaching: Shoulder Height - F
- Reaching: Above shoulder height -O
- Reaching: Below shoulder height - F
- Climbing - O
- Pulling/Pushing: 25 pounds or less - O
- Pulling/Pushing: 25 pounds to 50 pounds - O
- Pulling/Pushing: Over 50 pounds - O
- Lifting: 25 pounds or less - O
- Lifting: 25 pounds to 50 pounds - O
- Lifting: Over 50 pounds - O
- Carrying: 25 pounds or less - O
- Carrying: 25 pounds to 50 pounds - O
- Carrying: Over 50 pounds - O
- Crawling/Kneeling - O
- Bending/Stooping/Crouching -O
- Twisting/Turning - F
- Repetitive Movement - F
Working Conditions: - Normal office conditions.
Job Classification:- FLSA: Non-Exempt
- Hourly/Salary: Hourly
Physical Exposures For This Position:- Unprotected Heights - No
- Heat - No
- Cold - No
- Mechanical Hazards - No
- Hazardous Substances - No
- Blood Borne Pathogens Exposure Potential - No
- Lighting - Yes
- Noise - Yes
- Ionizing/Non-Ionizing Radiation - No
- Infectious Diseases - No
