Northern Arizona Healthcare · 5 hours ago
Revenue Integrity Analyst
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Responsibilities
Prepare and distribute monthly adjustment reports to Clinical areas for continued education
Prepare and distribute monthly revenue trend reports to specific Clinical areas for follow-up
Monitor and balance monthly charge/revenue reporting working with service lines and finance
Analyze complex financial data
Identify trends in revenue cycle operations
Summarize data and present reports to leadership
Serve as liaison with departments to thoroughly define reporting and information requirements
Evaluate revenue cycle workflows to identify areas for improvement
Oversee charge integrity, reconciliation, and charge linkages from ancillary charging systems
Train patient financial services units on revenue cycle systems, processes, and procedures
Maintain compliance with government regulations, reimbursement issues, etc.
Analyze hospital billing claims within the EHR and claim scrubber system
Resolve claim errors, edits, and other holds
Works with clinical and ancillary operational departments on the correct coding, billing, and charging principles protocol
Perform quantitative and financial analysis along with audits designed to identify opportunities for improvement across the full spectrum of the Revenue Cycle
Conduct analytical reviews to determine the net revenue effect of proposed charge master and fee schedule changes
Perform internal billing audits to ensure correct coding/billing regulatory compliance and charge capture accuracy
The incumbent must develop close working relationships with management and staff in Revenue Integrity, Finance, Information Technology, and Revenue and Clinical Operations, allowing them to perform deep-dive analyses and reviews that assist with identifying trends, solutions, and potential corrective action steps
Will work both independently and have a high level of self-directed work efforts as well as be an integral part of the Revenue Integrity Team
Participate in ongoing coordination and resolution of revenue issues as they arise
Assists in troubleshooting and resolving issues related to the patient revenue cycle, and assists in development and recommendations
Assist with Cerner performance reporting, including assisting with Revenue & Usage, Enterprise Charge Reconciliation, and Volume Reports
Assist in researching coding issues, provide guidance, and recommend solutions to account representatives
Analyze billing errors and denial data to identify the root cause of issues
Work with the Revenue Integrity Team, Clinical Operations, and Patient Financial Services staff to implement corrective actions to ensure compliant charges, prevent future rejections/denials, and ensure accurate reimbursement
Participate in ongoing coordination and resolution of revenue issues as they arise
Provide the Director and Manager input for the annual Revenue Integrity planning process
Assist with additional projects as needed
Qualification
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Required
High school diploma or G.E.D.
Ability to work collaboratively across disciplines and business lines
Exceptional oral/written communication skills and highly customer-focused
Excellent interpersonal and presentation skills
Able to communicate with many various customers
Ability to prioritize, plan and execute
Excellent critical thinking and analytical skillset experience
Proficiency with Microsoft Excel
Preferred
Associate’s Degree
At least one of the following preferred: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Revenue Cycle Representative (CRCR) or certification from AHIMA, AAPC, AAHAM, HFMA, and NAHRI
Five or more years of experience with hospital billing systems and third-party billing requirements
3 to 5 years Cerner Suite EHR or Sorian
Experience in revenue integrity operations, clinical charge capture, charge master, or revenue cycle operations
Knowledge of Tableau Reporting dashboards