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About the role
- Revenue Integrity Analyst II analyzing data and supporting charge capture processes for healthcare services. Collaborating across teams to ensure compliance and optimize revenue for assigned service lines.
Responsibilities
- Analyzes data, develops reports, reviews trends and recommends enhancements as defined by the revenue practice leadership team.
- Performs extensive data mining, mentoring/training, regulatory and payer policy review, abstracting of financial and clinical information from various sources.
- Presents, researches, and follows-up on topics reviewed at department and system-wide initiative levels.
- Monitors for positive or negative trends in coding, charge capture and/or editing processes to improve teams' performance.
- Researches and stays current on CMS, federal and state regulations, payor guidelines, ensuring compliance and alignment with charge, coding and charge edits.
- Audits and evaluates system automation by comparing the charge/claim data to the clinical record.
- Evaluates, provides education and guidance to revenue cycle, revenue practice teams and clinical operations on report development, charge capture accountability and revenue monitoring.
- Mentors and supports the training of other revenue integrity analysts.
Requirements
- Current certification through AAPC, AHIMA or HFMA, or other specialty medical coding group.
- Experience in a role requiring attention to detail with excellent organizational and analytical skills.
- Demonstrated proficiency with Epic clinical and/or billing applications.
- Demonstrates ability to be flexible and adaptable to change.
- Demonstrates ability to work in a clinical operational area and/or a revenue integrity team effectively supporting department outcomes.
- Experience working closely with a multi-disciplinary team to optimize patient experience and operational success.
- Demonstrates advanced knowledge of regulation, payer policy, charge capture and/or revenue monitoring.
Benefits
- generous benefits package including wellness programs
- flexible work options
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