Analyst, Revenue Integrity

Northwestern Medicine; Chicago (IL); Hybrid; USD 75,000 - 95,000; Full time

Job summary

The Revenue Integrity Analyst at Northwestern Medicine will work with the Senior Analyst to support clinical departments and revenue cycle functions. The role involves charge capture analysis, price increase reviews, and maintaining the charge master for compliance and accuracy across departments.

Key duties include audits of the EAP, identifying charge capture opportunities, researching billing regulations, and implementing necessary changes.

Qualifications

• Bachelor's degree in Business or related field or 10+ years of equivalent experience with progressive advancement.
• 3+ years of relevant experience
• Excellent communication, collaboration, analytical, and accounting skills
• High level of precision and attention to detail
• Expert knowledge of Microsoft Office Suite
• Moderate / Advanced understanding of CPT coding and third party billing requirements
• Knowledge and experience with Medicare/Medicaid regulations

Responsibilities

• Perform daily maintenance and quarterly audits of the EAP.
• Prepare necessary files for the EAP database of required department builds.
• Identify charge capture opportunities or compliance issues in revenue producing departments.
• Research billing and coding regulations. Communicate and assist in implement any necessary changes to impacted area that affect policy, financial, charge capture, patient care, billing, and coding operations.
• Assist in quarterly audits on the charge master data elements.
• Review departmental front-end charge capture tools for accuracy. Take necessary action to ensure accurate charging on patient accounts.
• Support complex audits and prepares methodology for annual pricing review and coding changes.
• Liaison with Revenue Cycle, IT and clinical departments to link EPIC and charge master.
• Consistently delivers concrete, relevant results. Displays qualities of resiliency and resourcefulness while thinking strategically and practically when problem solving. In addition to results orientation, displays business knowledge, speed and decisiveness, and project management.
• Supports the finance, operations and revenue cycle teams through special projects.
• Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, adopting and implementing industry best practices, and participating in professional societies.
• Protect operations by keeping financial and patient information confidential.
• Support the finance operations of Northwestern Medicine.

Skills

Communication

Analytical skills

Accounting

Attention to detail

Microsoft Office

CPT coding knowledge

Medicare/Medicaid regulations

Education

Bachelor's degree in Business or related field

10+ years of equivalent experience

Tools

EPIC Certification (Resolute Charge Capture)

Job description

Remote work from Illinois, Wisconsin, Indiana, and Iowa

Description

The Revenue Integrity Analyst reflects the mission, vision, and values of Northwestern Medicine, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

The Revenue Integrity Analyst will work directly with the Revenue Integrity Senior Analyst to support the Clinical Department and revenue cycle and perform charge capture analysis including annual price increase analysis. The Revenue Integrity Analyst will be responsible for helping maintain the charge master to ensure compliance, accuracy, and consistency for Northwestern Medicine.

Responsibilities

• Perform daily maintenance and quarterly audits of the EAP.
• Prepare necessary files for the EAP database of required department builds.
• Identify charge capture opportunities or compliance issues in revenue producing departments.
• Research billing and coding regulations. Communicate and assist in implement any necessary changes to impacted area that affect policy, financial, charge capture, patient care, billing, and coding operations.
• Assist in quarterly audits on the charge master data elements.
• Review departmental front-end charge capture tools for accuracy. Take necessary action to ensure accurate charging on patient accounts.
• Support complex audits and prepares methodology for annual pricing review and coding changes.
• Liaison with Revenue Cycle, IT and clinical departments to link EPIC and charge master.
• Consistently delivers concrete, relevant results. Displays qualities of resiliency and resourcefulness while thinking strategically and practically when problem solving. In addition to results orientation, displays business knowledge, speed and decisiveness, and project management.
• Supports the finance, operations and revenue cycle teams through special projects.
• Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, adopting and implementing industry best practices, and participating in professional societies.
• Protect operations by keeping financial and patient information confidential.
• Support the finance operations of Northwestern Medicine.

Qualifications

Required

• Bachelors Degree in Business or related field or 10+ years of equivalent experience with progressive advancement.
• 3+ years of relevant experience
• Excellent communication, collaboration, analytical, and accounting skills
• High level of precision and attention to detail
• Expert knowledge of Microsoft Office Suite
• Moderate / Advanced understanding of CPT coding and third party billing requirements
• Knowledge and experience with Medicare/Medicaid regulations

Preferred

• Healthcare finance experience
• EPIC Certification (Resolute Charge Capture)
• RHIA preferred or related health care credential (e.g. Radiology technician, RN)

Equal Opportunity

Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

Background Check

Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check. Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act.

Artificial Intelligence Disclosure

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person.

Benefits

We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.

Sign-on Bonus Eligibility (if sign-on bonus offered for position):

Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family.