Revenue Cycle Integrity Analyst

Highmark Health; Juneau (AK); On-site; USD 39,000 - 61,000; Full time

Job summary

Allegheny Health Network is seeking a Revenue Cycle Analyst to perform reporting and analysis of the revenue cycle, assist staff with internal and external system issues, audits and questions related to accounts receivable, and act as a liaison to resolve system issues and ensure regulatory compliance.

The role focuses on internal controls, training, and collaboration with Compliance, Budget Office, Patient Accounts, and Health Information Services to optimize revenue cycle processes and

Qualifications

• Minimum: High School/GED.
• 1-3 years in hospital or physician revenue cycle, billing, coding or billing.

Responsibilities

• Responsible for financial, statistical and operational projects; present detailed analysis of A/R performance and other financial reports and related outcomes/trends; researches and validates clinical data used to support medical necessity of billed services.
• Performs ad hoc consultative research and coordination on current issues of Revenue Cycle regulatory risk including medical necessity denials; identifies a framework of continuous improvement to accomplish programmatic goals.
• Responsible for monitoring and auditing of Revenue Cycle issues; monitor facility departments, Practices and RCC staff performance relative to current Revenue Cycle policies and procedures, including medical necessity issues of billed services through sample audits; research regulatory concepts for gaps and opportunities to improve Revenue Cycle compliance; identify under- and over-charge items for immediate resolution by the provider/practice; identify areas for risk as well as improvement - conducts assessments both desk level and on site.
• Provides ongoing education to departments, practices and RCC staff concerning practice management system, coding and regulatory complexities; develops and implements action and educational plans to target resolution of Revenue Cycle issues; identify training needs as well as appropriate hand-off for designated topics; assist with training and implementation of PM system for newly acquired Hospitals, ASC's and practices relative to front-end Revenue Cycle edits or other systematic issues and supportive medical record documentation.
• Collaborates with Compliance, Budget Office, Patient Accounts, Health Information Services, Internal Audit and other Revenue and Finance departments on revenue management initiatives.
• Develops and maintains a Quality Audit program and associated reporting; assists in performance of quality audits related to RI liason and charge review coordinators identified areas of opportunity.

Education

Bachelor's Degree in Business, Healthcare or related field

Job description

Allegheny Health Network is seeking a Revenue Cycle Analyst to perform reporting and analysis of the revenue cycle, assist staff with internal and external system issues, audits and questions related to accounts receivable, and act as a liaison to resolve system issues and ensure regulatory compliance.

The role focuses on internal controls, training, and collaboration with Compliance, Budget Office, Patient Accounts, and Health Information Services to optimize revenue cycle processes and