Orthopedic ONE · 1 day ago
Revenue Integrity Analyst
Westerville, OH
Full-time
Onsite
Mid Level
3+ years expOrthopedic ONE is a healthcare organization focused on ensuring accurate and compliant billing processes. The Revenue Integrity Analyst will analyze claims, resolve errors, manage charge master, and optimize revenue cycle performance in collaboration with the Director of Patient Accounts.
Health CareHospitalMedicalTherapeutics
Responsibilities
Analyze key performance indicators (KPI’s) revenue cycle metrics identifying trends, creating and maintaining reports and dashboards for leadership and performing root cause analysis on revenue cycle issues
Ensure the prevention of payment denials and claim resolution by investigating and correcting claim edits, denials, holds and system edits and billing rules set up
Overseeing charge master accuracy, testing updates and integrating new services. Updates CPT, HCPCS and revenue codes to ensure accurate pricing and billing transparency
Utilize variance tools to analyze fee schedules, identify overpayments or underpayments and work closely with payer contracts to ensure compliance
Determine appropriate methods to analyze operations, relevant information, and data. Create new queries and analysis tools, develop databases as needed and acquire desired data
Interprets results, identifies trends, and provides director with business insights and performance metrics using data analysis methods and modeling
Provide training and resources to clinical and billing staff on proper charging and documentation practices
Performs analysis on an ad hoc basis as required to support the operational needs of the Patient Accounts Department
Able to communicate effectively (written and verbal) the findings of analyses and audits to support operation and financial decisions
Acts a local support and super user in systems including EMR, clearinghouse and variance denials tools, working with all levels of associates to identify issues and root causes and make recommendations for process improvements
Provide project management support for leadership. Leads implementation plans to ensure stability of workflows and solutions
Assist in the development/coding, implementation and management of automation reports, dashboards, and other SQL-based analytics tools used for revenue cycle and other critical business functions
Create and manage documentation (such as SOPs and data dictionaries) for various data solutions, reports, and dashboards
Works cooperatively with coworkers, providers, and management
Shares knowledge and insights with co-workers in a constructive manner
Willingly provides coverage to department, staying beyond scheduled ending time when clinic schedule demands it, volunteering to cover time off or unexpected absences, maintaining workflow in department without direct supervision
Addresses conflicts with person directly before involving manager or uninvolved peers
Is considerate of others with regard to taking breaks or meal periods, use of computer and telephone, and noise in department
Knows and complies with policies and procedures as enumerated in the Orthopedic One Employee Handbook and policies and procedures documents
Provides assistance and support to leadership in implementing policies and procedures as necessary
Actively participates in training, and conducting day to day work activity by adhering to all policies and procedures as enumerated in compliance and risk management programs
Qualification
Required
A bachelor's or associate degree in Healthcare Administration, Finance, Health Information Systems, Statistics, or a related field is required
A combination of relevant education, training, and experience may be considered in lieu of a degree
A minimum of three years of professional experience, preferably in a healthcare setting, is required
Experience should include working with large datasets, developing complex queries and analyses, managing multiple projects, and preparing reports and presentations within a multidisciplinary team environment
This role requires a strong understanding of medical terminology, human anatomy, ICD10/CPT coding, and medical insurance reimbursement models
Candidates must demonstrate proficiency with Microsoft Office applications, including Excel, Teams, and PowerPoint
Excellent communication, analytical thinking, facilitation, problem-solving, and project leadership skills are essential
Preferred
SQL experience is preferred
Company
Orthopedic ONE
Orthopedic One is a health care firm that provides therapy, orthopedic surgery, musculoskeletal, imaging and sports medicines services.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Mark D'Aloisio
Chief Executive Officer
Recent News
2025-09-15
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2022-12-16
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