Revenue Integrity Analyst
City/StateNorfolk, VAOverviewWork ShiftFirst (Days) (United States of America)Reporting to the Revenue Integrity Manager, the Revenue Integrity Analyst plays an important role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions, and interdependencies from the provision of patient care to final bill generation.
Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, and superb analytic and organizational skills.
Job
Responsibilities:
With responsibility for all cost centers within service lines and acting with a high degree of autonomy, performs reviews and makes updates related to Charge Description Master (CDM) integrity.
Evaluates current charging processes to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements, to ensure consistency across all entities.
Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications.
Assesses the accuracy of all charging vehicles, including Epic and ancillary clinical systems and dictionaries, encounter forms, and other charge documents.
Provides guidance, communication, and education on correct charge capture, coding, and billing processes to multiple clinical departments and entities.
Participates in complex projects related to revenue cycle initiatives.
Collaborates with Revenue Operations, Compliance, Budget Offices, Patient Accounts, Health Information Services, Internal Audit, and other Revenue and Finance departments on revenue management initiatives, across all entities.
Develops, maintains, and implements Revenue Integrity and CDM Management policies, procedures, and training materials.
Work and analyze billing error and denial data to identify root causes.
Executes work plans to correct identified deficiencies.
Serves as subject matter expert (SME) of Epic charge capture methodologies and helps investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff.
Prepare monthly and year-to-date statistical reports using analytical tools to exemplify findings and ensure accurate financial reporting.
Participate in various special projects such as quarterly and annual CPT/HCPCS changes, annual pricing updates, and other related projects and duties as assigned.
Job Requirements:
Bachelor's degree required preferably in Healthcare Administration, Accounting, Finance, or a related field.
Three years of healthcare-related experienceRequires advanced proficiency in Microsoft Office Suite, especially in MS Excel.
Experience with EPIC P/R and Craneware (Chargemaster Toolkit/Online Reference Toolkit) is a plus.
Financial management skills, including the ability to financially analyze data for operations to provide guidance to department managersKnowledge of CPT/ HCPCS codes and Revenue Codes.
Understanding of revenue integrity processes and their impact throughout the revenue cycle.
Must demonstrate excellent communication skills including oral and written comprehension and expression.
Sentara Healthcare offers employees comprehensive health care and retirement benefits designed with you and your family's well-beingin mind.
Ourbenefits packages are designed to change with you by meeting yourneeds now and anticipating what comes next.
You have a variety of options for medical, dental and vision insurance, life insurance, disability and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave.
Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.
Job SummaryReporting to the Revenue Integrity Manager, the Revenue Integrity Analyst plays an important role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions, and interdependencies from the provision of patient care to final bill generation.
Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, and superb analytic and organizational skills.
Principal Duties and
Responsibilities:
Support the following service areas/departments:
Pharmacy, Cancer Centers, Rad Onc and Laboratory With responsibility for all cost centers within service lines and acting with a high degree of autonomy, performs reviews and makes updates related to Charge Description Master (CDM) integrity.
Evaluates current charging processes to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements, to ensure consistency across all entities.
Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications.
Assesses the accuracy of all charging vehicles, including Epic and ancillary clinical systems and dictionaries, encounter forms, and other charge documents.
Provides guidance, communication, and education on correct charge capture, coding, and billing processes to multiple clinical departments and entities.
Participates in complex projects related to revenue cycle initiatives.
Collaborates with Revenue Operations, Compliance, Budget Offices, Patient Accounts, Health Information Services, Internal Audit, and other Revenue and Finance departments on revenue management initiatives, across all entities.
Develops, maintains, and implements Revenue Integrity and CDM Management policies, procedures, and training materials.
Work and analyze billing error and denial data to identify root causes.
Executes work plans to correct identified deficiencies.
Serves as subject matter expert (SME) of Epic charge capture methodologies and helps investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff.
Prepare monthly and year-to-date statistical reports using analytical tools to exemplify findings and ensure accurate financial reporting.
Participate in various special projects such as quarterly and annual CPT/HCPCS changes, annual pricing updates, and other related projects and duties as assigned.
Bachelor's degree required preferably in Healthcare Administration, Accounting, Finance, or a related field.
Three years of healthcare-related experience.
Requires advanced proficiency in Microsoft Office Suite, especially in MS Excel.
Experience with EPIC P/R and Craneware (Chargemaster Toolkit/Online Reference Toolkit) is a plus.
Financial management skills, including the ability to financially analyze data for operations to provide guidance to department managers.
Knowledge of CPT/ HCPCS codes and Revenue Codes.
Understanding of revenue integrity processes and their impact throughout the revenue cycle.
Must demonstrate excellent communication skills including oral and written comprehension and expression.
Qualifications:
BLD - Bachelor's Level Degree:
Accounting, BLD - Bachelor's Level Degree:
Finance, BLD - Bachelor's Level Degree:
Health AdministrationCertified Outpatient Coder (COC) - Other/National, Certified Professional Coder (CPC) - Other/NationalHealthcareSkillsSentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce.
Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.
gov for further information.
In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission to improve health every day, this is a tobacco-free environment.
Recommended Skills Analytical Auditing Billing Certified Professional Coder Clinical Works Coordinating Estimated Salary: $20 to $28 per hour based on qualifications.
Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, and superb analytic and organizational skills.
Job
Responsibilities:
With responsibility for all cost centers within service lines and acting with a high degree of autonomy, performs reviews and makes updates related to Charge Description Master (CDM) integrity.
Evaluates current charging processes to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements, to ensure consistency across all entities.
Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications.
Assesses the accuracy of all charging vehicles, including Epic and ancillary clinical systems and dictionaries, encounter forms, and other charge documents.
Provides guidance, communication, and education on correct charge capture, coding, and billing processes to multiple clinical departments and entities.
Participates in complex projects related to revenue cycle initiatives.
Collaborates with Revenue Operations, Compliance, Budget Offices, Patient Accounts, Health Information Services, Internal Audit, and other Revenue and Finance departments on revenue management initiatives, across all entities.
Develops, maintains, and implements Revenue Integrity and CDM Management policies, procedures, and training materials.
Work and analyze billing error and denial data to identify root causes.
Executes work plans to correct identified deficiencies.
Serves as subject matter expert (SME) of Epic charge capture methodologies and helps investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff.
Prepare monthly and year-to-date statistical reports using analytical tools to exemplify findings and ensure accurate financial reporting.
Participate in various special projects such as quarterly and annual CPT/HCPCS changes, annual pricing updates, and other related projects and duties as assigned.
Job Requirements:
Bachelor's degree required preferably in Healthcare Administration, Accounting, Finance, or a related field.
Three years of healthcare-related experienceRequires advanced proficiency in Microsoft Office Suite, especially in MS Excel.
Experience with EPIC P/R and Craneware (Chargemaster Toolkit/Online Reference Toolkit) is a plus.
Financial management skills, including the ability to financially analyze data for operations to provide guidance to department managersKnowledge of CPT/ HCPCS codes and Revenue Codes.
Understanding of revenue integrity processes and their impact throughout the revenue cycle.
Must demonstrate excellent communication skills including oral and written comprehension and expression.
Sentara Healthcare offers employees comprehensive health care and retirement benefits designed with you and your family's well-beingin mind.
Ourbenefits packages are designed to change with you by meeting yourneeds now and anticipating what comes next.
You have a variety of options for medical, dental and vision insurance, life insurance, disability and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave.
Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.
Job SummaryReporting to the Revenue Integrity Manager, the Revenue Integrity Analyst plays an important role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions, and interdependencies from the provision of patient care to final bill generation.
Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, and superb analytic and organizational skills.
Principal Duties and
Responsibilities:
Support the following service areas/departments:
Pharmacy, Cancer Centers, Rad Onc and Laboratory With responsibility for all cost centers within service lines and acting with a high degree of autonomy, performs reviews and makes updates related to Charge Description Master (CDM) integrity.
Evaluates current charging processes to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements, to ensure consistency across all entities.
Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications.
Assesses the accuracy of all charging vehicles, including Epic and ancillary clinical systems and dictionaries, encounter forms, and other charge documents.
Provides guidance, communication, and education on correct charge capture, coding, and billing processes to multiple clinical departments and entities.
Participates in complex projects related to revenue cycle initiatives.
Collaborates with Revenue Operations, Compliance, Budget Offices, Patient Accounts, Health Information Services, Internal Audit, and other Revenue and Finance departments on revenue management initiatives, across all entities.
Develops, maintains, and implements Revenue Integrity and CDM Management policies, procedures, and training materials.
Work and analyze billing error and denial data to identify root causes.
Executes work plans to correct identified deficiencies.
Serves as subject matter expert (SME) of Epic charge capture methodologies and helps investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff.
Prepare monthly and year-to-date statistical reports using analytical tools to exemplify findings and ensure accurate financial reporting.
Participate in various special projects such as quarterly and annual CPT/HCPCS changes, annual pricing updates, and other related projects and duties as assigned.
Bachelor's degree required preferably in Healthcare Administration, Accounting, Finance, or a related field.
Three years of healthcare-related experience.
Requires advanced proficiency in Microsoft Office Suite, especially in MS Excel.
Experience with EPIC P/R and Craneware (Chargemaster Toolkit/Online Reference Toolkit) is a plus.
Financial management skills, including the ability to financially analyze data for operations to provide guidance to department managers.
Knowledge of CPT/ HCPCS codes and Revenue Codes.
Understanding of revenue integrity processes and their impact throughout the revenue cycle.
Must demonstrate excellent communication skills including oral and written comprehension and expression.
Qualifications:
BLD - Bachelor's Level Degree:
Accounting, BLD - Bachelor's Level Degree:
Finance, BLD - Bachelor's Level Degree:
Health AdministrationCertified Outpatient Coder (COC) - Other/National, Certified Professional Coder (CPC) - Other/NationalHealthcareSkillsSentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce.
Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.
gov for further information.
In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission to improve health every day, this is a tobacco-free environment.
Recommended Skills Analytical Auditing Billing Certified Professional Coder Clinical Works Coordinating Estimated Salary: $20 to $28 per hour based on qualifications.
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