Children's Hospital of Philadelphia · 16 hours ago
Revenue Integrity Analyst
United States
Full-time
Remote
Mid, Senior Level
$74K/yr - $95K/yr
3+ years expChildren’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. The Revenue Integrity Analyst plays a pivotal role in ensuring accurate charge capture, billing and reimbursement across the revenue cycle, collaborating closely with various teams to improve processes and optimize reimbursement.
Child CareHealth CareHospitalMedicalNon Profit
Responsibilities
Focus on review, correction, trending and prevention of denials within Revenue Integrity’s control
Review, identify, analyze EPIC work queues, reports and claim data to identify root cause of denials
Works with the RI Specialist and their revenue producing departments to help minimize charge capture methods that may be contributing to denials by analyzing trends in payments and denials, identifying discrepancies, and collaborating with them to resolve issues, prevent revenue leakage
Perform applicable analyses to understand net revenue effect of any proposed charge capture changes
Perform internal billing audits to ensure correcting coding/billing regulatory compliance and charge capture accuracy
Serves as resource to Patient Financial Services staff for reporting problems and denials on individual claims. Assists in researching coding issues and recommends solution to account representative. Identifies source of problem and works with analysts to implement corrective actions to ensure that the charge capture is updated to prevent future rejections/denials and to ensure accurate and expedient reimbursement
Assist in strategic pricing process to optimize reimbursement within budget guidelines
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
Performs other duties as assigned
Qualification
Required
Associate's Degree Business, Healthcare or related field
At least three (3) years Hospital or physician revenue cycle, billing, or coding
Knowledge of healthcare revenue cycle functions, and billing and collection processes specific to the charge master
Knowledge of CMS local, state, and federal regulatory and the various data elements associated with all types of claim forms
Identifies data and analytic challenges including data integrity, appropriateness of data sample, context and consistency between sources
Experience supporting RI initiatives specific to implementation, and/or major process improvement and redesign
Plans effectively yet is fluid based on the atmosphere and needs of the audience. Connects with the group. Is masterful and an engaging listener
Preferred
Bachelor's Degree Business, Healthcare or related field
At least five (5) years Experience with coding, billing and CDM maintenance
Certified Outpatient Coder (CPC-H) - American Academy of Professional Coders (AAPC) - within 12 months
Company
Children's Hospital of Philadelphia
Since its start in 1855 as the nation's first hospital devoted exclusively to caring for children, The Children's Hospital of Philadelphia has been the birthplace for many dramatic firsts in pediatric medicine.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$33.35MKey Investors
UnitedHealthcare Community PlanNational Cancer InstituteBill & Melinda Gates Foundation
2025-12-10Grant· $1.7M
2025-09-29Grant· $1M
2025-06-18Grant· $1M
Leadership Team
Ron Keren
Senior Vice President and Chief Medical Officer
Adam Resnick
Director of the Center for Data Driven Discovery in Biomedicine (D3b)
Recent News
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