Revenue Integrity Analyst

SouthEast Alaska Regional Health Consortium; Juneau (AK); On-site; USD 44,000 - 61,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

Paid time off

Paid parental leave

Job summary

SouthEast Alaska Regional Health Consortium in Juneau, Alaska is seeking a Revenue Cycle Applications Analyst to optimize and troubleshoot our revenue cycle systems, including charge capture, compliance, and contract payments.

You will collaborate with clinical and operational teams, analyze data, support system design, and provide guidance to departments on registration, coding, billing, and reporting to reduce denials and improve financial performance.

Qualifications

• Bachelor's degree or equivalent required.
• 2 years of Revenue Cycle, Finance, or Clinical experience preferred.
• Certifications such as AAHAM / AAPC / AHIMA / PTCB preferred.

Responsibilities

• Optimize and troubleshoot revenue cycle applications.
• Collaborate with clinical and operational stakeholders to design integrated solutions.
• Analyze data to support Revenue Cycle initiatives and resolve system deviations.
• Serve as an internal resource on registration, authorizations, coding, CDI, CDM management, denials, and reporting.
• Perform workflow analysis and payer contract analysis to ensure contract-compliant payments.
• Identify root causes of denials and partner with finance to address issues and training gaps.
• Provide QA, validation, and education to patient revenue-generating departments.

Skills

Critical thinking

Problem solving

Troubleshooting

Solution design

MS Office

EHR applications

Multitasking

Teamwork

Education

Bachelor's degree or equivalent

AAHAM / AAPC / AHIMA / PTCB certification

Tools

UB-04

CMS 1500

837I/P

NCPDP D.0

Job description

Pay Range:Pay Range:$31.83 - $44.56 Responsible for improving the charge capture, reimbursement, and quality of the revenue cycle through the support and management of revenue cycle applications; process automation, Charge Description Master, Claims, analysis, reporting, clinical and departmental integration, and performance of compliance, contract payment, and denials auditing.SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more.Key Essential Functions and Accountabilities of the JobOptimization and troubleshooting of revenue cycle applicationsCollaboration with clinical, operational, supporting departments, applicable stakeholders, for development of integrated design solutionsAnalysis of available data to support Revenue Cycle team initiatives in identification, definition, resolution planning, and implementation for system & user deviations, inconsistencies, and process failuresServes as an internal resource on a combination of the topics of registration, authorizations, coding, CDI, CDM management, claims, edits, billing compliance, denials, remittance processing, and/or reporting & analyticsWorkflow analysisPayer contract analysis and ensuring payments consistent with negotiated contractsIdentification of root causes of issues driving controllable denials, partnering with finance leadership to address implicated operational issues, workflow issues, and training gapsPerforms quality assurance and validation tasksProvides education and guidance to patient revenue generating departments/providers to ensure appropriate charge captureEducation, Certifications, and Licenses RequiredBachelor's degree or an equivalent combination of education and/or work experience – Required4 years of work experience may be exchanged for a bachelor's degreeAAHAM, AAPC, AHIMA, PTCB, or other professional certification or licensure - PreferredExperience Required2 years of experience Revenue Cycle, Finance, or Clinical capacityKnowledge ofEnd user workflows including scheduling, registration, clinical, ancillary, coding, billing and claims processing, cash posting, and/or reportingNational and International code sets including ICD 10CM, DSM, CPT, HCPCS, Revenue Codes, CARC/RARC, NCCIPayer edits, rejections, rules, and appropriate actions and requirements for resolutionBilling, accounts receivable, collection practices, and/or reporting requirements for IHS, CAH, FQHC, Provider Based, LTC, Rehab, Behavioral Health (CBH, SUD, 1115), and/or Retail Pharmacy enrollmentsFile structure, configuration, requirements, and troubleshooting of UB 04, CMS 1500, 837I/P, 835, and/or NCPDP D.0Resources, references, statutes, governing the instruction, policy, and procedure for participation in, and billing, for various State, Federal, and Commercial programsSkills inCritical thinking (problem solving, troubleshooting)Creative solution design and execution for complex problemsExposure to Microsoft Office programs, including Word, ExcelElectronic Health Record applicationsAbility toWork on different projects simultaneously, multitasking in a fast-paced environment, appropriately handle overlapping commitments and deadlinesImplement a systematic, self-motivated approach to problem solvingWork independently and collaboratively as neededRequired Certifications:If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!