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Mercyhealth Wisconsin and Illinois · 2 months ago

RN Revenue Integrity Analyst

Janesville, WI

Full-time

Onsite

Senior Level

5+ years exp

Mercyhealth Wisconsin and Illinois is seeking a Revenue Integrity RN Analyst to enhance the revenue integrity team's efforts in bridging clinical departments and charge improvement processes. The role involves monitoring charge capture functions, evaluating coding structures, and ensuring compliance with billing regulations to improve revenue results.

Health CareNon Profit

Responsibilities

Interacts with clinical department directors to monitor charge capture functions across all entities

Evaluates current charging and coding structures and processes in clinical departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements

Completes focused charge review assessments for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes

Advises service line leaders and their staff on proper usage of charge codes; identifies opportunities for capturing additional revenue in accordance with payer guidelines; develops specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections

Provides guidance and communication on correct change capture, coding and billing processes to clinical departments and facilities

Monitors EPIC Revenue Integrity Dashboard(s)

Participates in moderately complex projects related to revenue integrity initiatives

Provide support for assigned cost centers within service lines

Participates in analyzing changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars and publications

Train and assist clinical team with revenue integrity functions

Performs miscellaneous duties as assigned

Completes and/or attends mandatory training and education sessions within approved organizational guidelines and timeframes

Comfortable in presenting to and interacting with levels of hospital management and with clinical leaders

Excellent organizational and project management skills

Strong time management, attention to detail, and follow through

Well-developed research skills

Interacts professionally with coworkers and customers to represent the Revenue Integrity Department positively

Work effectively as a team contributor on all assignments

Works independently while understanding the necessity for communicating and coordinating work efforts with other employees and organizations

Delivers positive patient experience, where applicable

Qualification

Revenue cycle managementHealthcare billing knowledgeCPT/HCPCS codingAnalytical skillsEPIC HB/PB experienceResearch skillsProject managementTime managementTeam collaboration

Required

Background in revenue cycle management, financial operations, or Clinical Documentation Improvement (CDI)

Strong analytical skills with the ability to interpret complex data and provide actionable insights

Comprehensive knowledge of healthcare billing, coding practices, and regulatory compliance standards

RN or medical coding background

In excess of five (5) years' experience in the hospital setting, healthcare industry or coding with a focus in one or more of the following areas: charge integrity; charge reconciliation; charge compliance; charge auditing; hospital leadership

Excellent organizational and project management skills

Strong time management, attention to detail, and follow through

Well-developed research skills

Interacts professionally with coworkers and customers to represent the Revenue Integrity Department positively

Work effectively as a team contributor on all assignments

Works independently while understanding the necessity for communicating and coordinating work efforts with other employees and organizations

Delivers positive patient experience, where applicable

Preferred

Clinical leadership experience preferred with high level focus charges/revenue

EPIC HB/PB experience preferred

Knowledge of CPT/HCPCS procedural coding preferred

Benefits

Comprehensive Benefits Package: Mercyhealth offers a retirement plan with competitive matching contribution, comprehensive medical, dental, and vision insurance options, life and disability coverage, access to flexible spending plans, and a variety of other discounted voluntary benefit options.

Competitive Compensation: Mercyhealth offers market competitive rates of pay and participates in various shift differential and special pay incentive programs.

Paid Time Off: Mercyhealth offers a generous paid time off plan, which increases with milestone anniversaries, to allow employees the opportunity for a great work-life balance.

Career Advancement: Mercyhealth offers a number of educational assistance programs and career ladders to support employees in their educational journey and advancement within Mercyhealth.

Employee Wellbeing: Mercyhealth has a focus on wellbeing for employees across the organization and offers a number of tools and resources, such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey.

Additional Benefits: Mercyhealth employees have access to our internal and external employee assistance programs, employee-only discount packages, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services, and financial education to help with retirement planning.