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Company

Northern Arizona Healthcare · 4 hours ago

Revenue Integrity Analyst

Flagstaff, AZ

Full-time

Remote

Mid, Senior Level

5+ years exp

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Responsibilities

Prepare and distribute monthly adjustment reports to Clinical areas for continued education

Prepare and distribute monthly revenue trend reports to specific Clinical areas for follow-up

Monitor and balance monthly charge/revenue reporting working with service lines and finance

Analyze complex financial data

Identify trends in revenue cycle operations

Summarize data and present reports to leadership

Serve as liaison with departments to thoroughly define reporting and information requirements

Evaluate revenue cycle workflows to identify areas for improvement

Oversee charge integrity, reconciliation, and charge linkages from ancillary charging systems

Train patient financial services units on revenue cycle systems, processes, and procedures

Maintain compliance with government regulations, reimbursement issues, etc.

Analyze hospital billing claims within the EHR and claim scrubber system

Resolve claim errors, edits, and other holds

Works with clinical and ancillary operational departments on the correct coding, billing, and charging principles protocol

Perform quantitative and financial analysis along with audits designed to identify opportunities for improvement across the full spectrum of the Revenue Cycle

Conduct analytical reviews to determine the net revenue effect of proposed charge master and fee schedule changes

Perform internal billing audits to ensure correct coding/billing regulatory compliance and charge capture accuracy

The incumbent must develop close working relationships with management and staff in Revenue Integrity, Finance, Information Technology, and Revenue and Clinical Operations, allowing them to perform deep-dive analyses and reviews that assist with identifying trends, solutions, and potential corrective action steps

Will work both independently and have a high level of self-directed work efforts as well as be an integral part of the Revenue Integrity Team

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

Assist with Cerner performance reporting, including assisting with Revenue & Usage, Enterprise Charge Reconciliation, and Volume Reports

Assist in researching coding issues, provide guidance, and recommend solutions to account representatives

Analyze billing errors and denial data to identify the root cause of issues

Work with the Revenue Integrity Team, Clinical Operations, and Patient Financial Services staff to implement corrective actions to ensure compliant charges, prevent future rejections/denials, and ensure accurate reimbursement

Participate in ongoing coordination and resolution of revenue issues as they arise

Provide the Director and Manager input for the annual Revenue Integrity planning process

Assist with additional projects as needed

Qualification

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Charge captureRevenue cycle operationsCerner Suite EHRRoot cause analysisMicrosoft ExcelTableau ReportingCoding principlesHospital billing systemsCompliance knowledgePatient revenue cycle

Required

High school diploma or G.E.D.

Ability to work collaboratively across disciplines and business lines

Exceptional oral/written communication skills and highly customer-focused

Excellent interpersonal and presentation skills

Able to communicate with many various customers

Ability to prioritize, plan and execute

Excellent critical thinking and analytical skillset experience

Proficiency with Microsoft Excel

Preferred

Associate’s Degree

At least one of the following preferred: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Revenue Cycle Representative (CRCR) or certification from AHIMA, AAPC, AAHAM, HFMA, and NAHRI

Five or more years of experience with hospital billing systems and third-party billing requirements

3 to 5 years Cerner Suite EHR or Sorian

Experience in revenue integrity operations, clinical charge capture, charge master, or revenue cycle operations

Knowledge of Tableau Reporting dashboards