Role Description
The Revenue Integrity Analyst II position is a Full Time Day Shift Remote position.
•
Works to improve the accuracy, integrity and quality of patient charges and to ensure minimal variation in charging practices.
•
Responsible for collaborating with Revenue Cycle and clinical departments to ensure accurate and thorough high level analysis of governmental and commercial payer regulations related to authorization, coding and billing guidelines.
•
Maintains current knowledge regarding coding guidelines, changing/billing regulations and regulatory agency activities.
Essential Functions:
•
Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
•
Primary clinical service-line liaison regarding payor guidelines, explaining regulatory requirements, and ensuring accountability and solid charge workflows for revenue integrity.
•
Serves as the subject matter expert for clinical departments on issues related to revenue cycle.
•
Identifies charge edit trends based on documentation, coding or charging issues and recommends workflow opportunities.
•
Completes focused charge review assessments for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes.
•
Serves as the service-line liaison between Revenue Cycle and clinical department administration regarding revenue, regulatory.
•
Develops processes to modify existing charge capture applications to reduce charge-related claim edits/rejections.
•
Advises service-line leaders and their staff on proper usage of charge codes; identifies opportunities for capturing additional revenue in accordance with payer guidelines.
•
Reviews Charge Description Master change requests for accuracy and appropriateness; approves additions, deletions, and modifications to charges.
•
Prepares revenue cycle meeting materials and facilitates clinical service-line Revenue Cycle department meetings.
•
Collaborates with clinical department personnel to analyze Charge Description Master billing processes and identify root causes for claims issues/rejections; investigates complex issues as necessary; makes recommendations for solutions to management.
•
Assists in the development and implementation of effective chargemaster review, education and training.
Qualifications
•
Bachelor’s or Associate’s degree in Health Information Management, Business Administration, Accounting, Management, Healthcare Administration.
Requirements
•
Must hold and maintain one or more of the following credentials: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC).
•
Applicable professional certifications from American Association of Healthcare Administrative Management (AAHAM) or Healthcare Financial Management Association (HFMA) preferred.
•
Five years experience in a hospital setting or within the healthcare industry strongly preferred.
•
1 – 3 years of experience related to auditing and/or coding is required.
•
Knowledge of Medicare/Medicaid regulations, including billing, coding and documentation requirements.
•
Understanding of various reimbursement systems including IPPS, OPPS and fee schedule.
•
Strong oral and written communication skills.
•
Ability to research, analyze and interpret healthcare policies, billing guidelines, and state and federal regulations.
•
Ability to document clinical workflows impacting revenue cycle.
•
Strong written communication, presentation skills, and excellent customer service skills.
•
Excellent organizational and project management skills.
•
Strong time management, attention to detail, and follow through.
•
Motivated individual who can mentor and inspire in a team environment.
Benefits
•
Comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits.
•
Access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
•
All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.
Location: , ,
Remotive: Apply Here