St. Charles Health System · 4 hours ago

Revenue Integrity Operations Analyst

Remote Oregon

Full-time

Remote

Entry, Mid Level

$28.94/hr - $43.40/hr

1+ years exp

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Responsibilities

Reviews and corrects issues with hospital-based charges triggering 3rd Party Edits or Revenue Guardian Checks.

Maintains and updates master list of edits and revenue guardian checks for hospital-based services for SCHS.

Audits, trains, and educates internal RI caregivers and clinical department caregivers assigned to working edits, revenue guardian checks and RI owned work queues.

Serves as a back-up to the Chargemaster team as departmental/organizational needs dictate. This includes attending annual chargemaster reviews.

Researches and resolves CPT code, revenue code, and other issues.

Identifies services that are reimbursable but are not being coded or charged; reviews, assigns, and validates charge information such as correct revenue codes and CPT/HCPC codes.

Supports clinical areas and departments in charge capture, coding accuracy, resolution of regulatory and payer specific edits, and revenue management to ensure organization-wide uniformity of charges and coding for similar services and procedures.

Identifies/investigates issues with medical necessity, coding, and billing that reduce reimbursement; recommends action steps and works collaboratively with the departments and clinics to improve processes when operational weaknesses and/or compliance issues are found.

Leads meetings with RI and other St Charles departments.

Completes and provides reports to leadership as requested.

Completes EHR build, system maintenance, troubleshooting and resolution tasks within certification scope. Investigates standardization and process improvement opportunities while making build decisions.

Designs and executes application testing as required.

Troubleshoots, identifies root cause, and documents problems for assigned Epic applications. Works directly with Epic Technical Support to determine appropriate resolution to operational requirements and issues.

Supports the vision, mission, and values of the organization in all respects.

Supports Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.

Provides and maintains a safe environment for caregivers, patients, and guests.

Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies, and procedures, supporting the organization’s corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

Delivers customer service and/or patient care in a manner that promotes goodwill, is timely, efficient and accurate.

May perform additional duties of similar complexity within the organization, as required or assigned.

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.

CPT codingRevenue codesEpic Revenue Cycle BuilderRHITAuditing experienceCoding experienceCharge captureLean principlesTraining skillsCHRICRCRCPMA