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.
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