Adventist Health · 4 hours ago

Revenue Integrity Analyst

United States

Full-time

Remote

Mid Level

3+ years exp

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Responsibilities

Independently interprets insurance contracts, government regulations and other non-contracted reimbursement methods to implement and maintain a reimbursement system which accurately calculates expected payments and contractual adjustments from all payers at one or more entities

Establishes and organizes a systematic transparent revenue integrity audit and improves processes with ongoing tracking, metrics and reporting that demonstrates progress.

Analyzes payment/contractual adjustment/other system variances and performs detailed reimbursement review to decide whether corrective action is required within the reimbursement system, other revenue cycle departments, and/or with the payer

Collaborates with Revenue Cycle departments on contract, revenue cycle and payer practice issues in order to increase revenue integrity

Performs other job-related duties as assigned.

Qualification

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Revenue Cycle ManagementReimbursement AnalysisInsurance Contract InterpretationMetricsCertified Revenue Cycle RepresentativeGovernment Regulations KnowledgeManaged Care ContractingCollaboration Skills