Revenue Integrity Analyst

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

Benefits offered by this job

Health insurance

Retirement plan

Paid time off

Parental leave

Dental and vision benefits

Life insurance

Long & short-term disability

Job summary

SouthEast Alaska Regional Health Consortium (SEARHC) seeks a Revenue Cycle Applications Specialist to optimize charge capture, reimbursement, and reporting across revenue cycle systems. You will partner with clinical and operational teams to implement integrated design solutions and improve denials management.

The role requires 2+ years in revenue cycle or related fields, a Bachelor’s degree or equivalent, and familiarity with ICD/CPT and UB/ CMS data.

Qualifications

• Bachelor's degree or equivalent work experience required.
• 2 years of revenue cycle, finance, or clinical experience preferred.
• AAHAM, AAPC, AHIMA, PTCB or other certification preferred.

Responsibilities

• Optimize and troubleshoot revenue cycle applications.
• Collaborate with clinical and operational teams to design integrated solutions.
• Analyze data to support Revenue Cycle initiatives and issue resolution.
• Act as a resource on registration, authorizations, coding, billing, denials, and reporting.
• Conduct workflow analysis and root-cause identification with Finance.

Skills

Revenue cycle

Data analysis

Problem solving

End user workflows

Education

Bachelor's degree

Certifications (AAHAM/AHIMA/AAPC)

Tools

Microsoft Excel

EHR software

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.

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 Job

• Optimization and troubleshooting of revenue cycle applications
• Collaboration with clinical, operational, supporting departments, applicable stakeholders, for development of integrated design solutions
• Analysis of available data to support Revenue Cycle team initiatives in identification, definition, resolution planning, and implementation for system & user deviations, inconsistencies, and process failures
• Serves 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 & analytics
• Workflow analysis
• Payer contract analysis and ensuring payments consistent with negotiated contracts
• Identification of root causes of issues driving controllable denials, partnering with finance leadership to address implicated operational issues, workflow issues, and training gaps
• Performs quality assurance and validation tasks
• Provides education and guidance to patient revenue generating departments/providers to ensure appropriate charge capture

Education, Certifications, And Licenses Required

• Bachelor's degree or an equivalent combination of education and/or work experience – Required
• 4 years of work experience may be exchanged for a bachelor's degree
• AAHAM, AAPC, AHIMA, PTCB, or other professional certification or licensure - Preferred

Experience Required

• 2 years of experience Revenue Cycle, Finance, or Clinical capacity

Knowledge of

• End user workflows including scheduling, registration, clinical, ancillary, coding, billing and claims processing, cash posting, and/or reporting
• National and International code sets including ICD 10CM, DSM, CPT, HCPCS, Revenue Codes, CARC/RARC, NCCI
• Payer edits, rejections, rules, and appropriate actions and requirements for resolution
• Billing, 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 enrollments
• File structure, configuration, requirements, and troubleshooting of UB 04, CMS 1500, 837I/P, 835, and/or NCPDP D.0
• Resources, references, statutes, governing the instruction, policy, and procedure for participation in, and billing, for various State, Federal, and Commercial programs

Skills In

• Critical thinking (problem solving, troubleshooting)
• Creative solution design and execution for complex problems
• Exposure to Microsoft Office programs, including Word, Excel
• Electronic Health Record applications

Ability to

• Work on different projects simultaneously, multitasking in a fast-paced environment, appropriately handle overlapping commitments and deadlines
• Implement a systematic, self-motivated approach to problem solving
• Work independently and collaboratively as needed

Required Certifications

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!