Be an early applicantLess than 25 applicants

Company

Ensemble Health Partners · 3 hours ago

Revenue Integrity Analyst

United States

Full-time

Remote

Mid Level

$45K/yr - $82K/yr

3+ years exp

Maximize your interview chances

Health CareHospitality

Insider Connection @Ensemble Health Partners

Discover valuable connections within the company who might provide insights and potential referrals.
Get 3x more responses when you reach out via email instead of LinkedIn.

Responsibilities

Evaluates current charging processes to diagnose the root cause of any charge inefficiencies and ensures standard charge practices are implemented.

Analyzes changes to coding and billing rules and regulations and using independent decision making to ensure appropriate updates to CDM and charge processes are implemented.

Prepare and present quarterly and annual CPT/HCPCS changes, annual pricing updates and provide client education material and presentation.

Conduct thorough research to ensure the Charge Description Master (CDM) is maintained regularly.

Leads efforts of collaboration with multi-disciplinary groups responsible for monitoring and assuring the accuracy and enhancement of hospital net revenue through management of the hospital charge master.

Collaborates with stakeholders in revenue enhancement projects including Denial Management, APC Billing and/or other committees as needed.

Provides leadership and expertise with various groups to develop new areas of review for future revenue enhancement and/or compliance initiatives.

Conduct thorough analysis of billing errors and denial data to diagnose root causes.

Utilizes independent decision making to execute work plans to correct identified deficiencies related to charge problems.

Responsible for problem solving and resolution of complex claim edits.

Stay up-to-date with industry trends, emerging technologies, and regulatory changes affecting healthcare revenue cycle management and proactively share knowledge with the team.

Perform Quality Assurance on team members, as needed.

Trending and analysis of key data to identify areas for additional education.

Serves as subject matter expert (SME) of charge capture methodologies and helps investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff.

Collaborate with client leadership to ensure charge trigger matrix is clearly documented and updated, as needed.

Diagnoses root cause issues of charge problems and provides client education for best practice recommendations for improvement.

Conduct root cause analysis on late charge reporting and provide client education for timely charge capture.

Ensure effective monitoring and internal control processes in place to improve revenue capture.

Rounding on client revenue leaders on a quarterly basis to review questions concerning charge reconciliation, charge processes, CDM.

Attend meetings to support system conversions, revenue cycle initiatives and foster good working relationships with key contacts.

Identify operational performance and revenue opportunities through detailed data review.

Ensure effective monitoring and reporting control processes in place to improve performance.

Evaluation of current processes and tools and propose changes in order to drive efficiencies within Revenue Cycle.

Coordinate operational objectives by contributing information and recommendations to strategic plans and reviews; preparing and completing action plans.

This position will be proactive in auditing and reconciling his/her own data findings, report results in order to maintain improve the quality and integrity data provided by the analyst.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Charge Master ManagementRevenue Cycle ManagementCPT & HCPCS CodingEpicSQL QueriesExcelQuality AssuranceRoot Cause AnalysisData ReviewClient EducationOperational Improvement

Required

3-5 years related experience required

Excellent knowledge of Epic, Excel and SQL queries.

Working knowledge of CPT & HCPCs coding guidelines.

Excellent computer, proof reading, and written and verbal communication skills.

Excellent interpersonal skills including the ability to communicate effectively with CHP internal and external customer base.

Ability to work independently, proactively with limited supervision and also as a team player when called upon.

Ability to work under pressure.

Ability to maintain the security of confidential information.

Bachelor’s Degree or equivalent experience

CRCR Required within 9 months of hire (company paid)

Benefits

Bonus Incentives

Paid Certifications

Tuition Reimbursement

Comprehensive Benefits

Career Advancement

Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.

Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.

Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.