R1 RCM · 2 days ago

Revenue Integrity Analyst

United States

Full-time

Remote

Mid Level

$44K/yr - $60K/yr

3+ years exp

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Responsibilities

Developing and implementing pricing strategies for various services and procedures, considering factors like costs, market rates, and reimbursement policies.

Ensuring that hospital policies and procedures related to billing and coding are followed by all relevant departments.

Analyzing billing trends and identifying opportunities for revenue improvement or areas of potential compliance risk.

Review and analyze patient records, billing data, and financial statements to ensure accurate charge capture.

Identify discrepancies or errors in charge capture processes and rectify them.

Verify that medical codes (ICD-10, CPT, HCPCS) assigned to procedures and diagnoses are accurate and compliant with coding guidelines.

Analyze payer contracts and reimbursement rates to ensure that services are billed and reimbursed appropriately.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Certified Professional CoderCertified Outpatient CoderHospital Based CDM experienceHealthcare reimbursement methodologiesCoding systems knowledgeBilling regulations knowledgeExcelVlookup functionParagon experienceMeditech experienceCerner Millenium experience