Luminis Health · 3 hours ago
Senior Revenue Integrity Analyst
Annapolis, MD
Full-time
Onsite
Senior Level
$95K/yr - $118K/yr
5+ years expLuminis Health is a healthcare organization, and they are seeking a Senior Revenue Integrity Analyst. This role focuses on charge capture and integrity, supporting initiatives related to charge reconciliation, audits, and compliance within the revenue cycle.
Health CareMedicalNon Profit
Responsibilities
Manages and tracks all hospital 3rd party payer audits; performs defense audits and educates clinical departments on lost payment opportunities
Performs internal review of Revenue Cycle processes
Collects, disseminates and educates clinical departments on all state and federal billing/coding/charging updates
Provides charge capture education to clinical departments
Performs CDM audits in accordance with Luminis Health Chargemaster Review Policy
Proficient Use of Support Systems
Efficient utilization of billing system database to update, Charge Description Master (CDM); ensures broad understanding of all areas of revenue cycle including pre-AR, actualized AR review and router logic
Ability to appropriately edit charges via Charge Router and document actions via notes in the Resolute billing system
Demonstrated ability to utilize Outlook email and navigate in the Word and Excel software applications
Competence in Coding, Billing and Charge Integrity Workflows
Evaluates current charging and coding structures in clinical, coding and Revenue Cycle departments to ensure appropriate capture and reporting of revenue and compliance with state/federal government and third-party payer requirements
Assess the accuracy and build of all Charge Capture related workflows in EPIC, including documentation, automation enhancements
Demonstrates the ability to understand and utilize payer rejections and remittance denials to execute denial management strategies in an effort to mitigate the risk of future denials
Organizational Efficiency
Effectively maintains audit and account activity by ensuring the proper organization, tracking, filing and documenting of all correspondence
Assists in proactive communication and root cause analysis of challenges impacting final adjudication of claims, including but not limited to system or payer issues
Provides Outstanding Customer Service
Creates a cross-collaborate approach with, billing teams, Coding, HIM and other key stakeholders to improve charge capture, compliant documentation to substantiate charges, charge reconciliation and compliant billing of all charges
Qualification
Required
BS in Finance, Accounting or Healthcare related field preferred
In lieu of BS degree, 10 years of hospital Revenue Cycle/Revenue Integrity experience preferred
5-7 years experience supporting Revenue Cycle and Clinical systems
Works well in environment with firm deadlines; results oriented
Demonstrates strong knowledge of end to end revenue cycle
Experience in EPIC required
Experience with Microsoft Office, Word and Excel
Ability to communicate professionally via internet and virtual communication tools
Coding certification required (CPMA, CPC, CBCS or CCS)
Benefits
Medical, Dental, and Vision Insurance
Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
Paid Time Off
Tuition Assistance Benefits
Employee Referral Bonus Program
Paid Holidays, Disability, and Life/AD&D for full-time employees
Wellness Programs
Employee Assistance Programs and more*Benefit offerings based on employment status
Company
Luminis Health
Luminis Health is a not for profit organization that provides exceptional health care services.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Amy Beales
Chief Human Resources Officer
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