Revenue Integrity Analyst

Saint Luke's Limited; Kansas City (MO); Remote; USD 70,000 - 110,000; Full time

Benefits offered by this job

Bonus program

Career advancement program

Job summary

Saint Luke’s Health System seeks a Revenue Integrity Analyst to improve charge capture accuracy through audits, education, and process enhancements. This tele-commuting role requires KC metro residency due to travel to area clinics. The analyst partners with leadership and IT to drive coding compliance and reimbursement optimization.

Requires CPC/CCS and CPMA/CEMA, 3–5 years coding, 2 years auditing, and EPIC experience. Exempt, with a bonus program and career ladder opportunities.

Qualifications

• 3–5 years of experience as a coder.
• 2 years of auditing/chart reviews experience.
• Bachelor's Degree and HA coding knowledge.
• Proficiency with documentation guidelines.

Responsibilities

• Analyze and conduct chart audits andeducation for providers.
• Audit focused requests from internal reviews and payor programs.
• Research regulatory requirements and payor policies affecting charging.
• Identify education opportunities from data such as revenue, denials, CPTs.
• Train departments on charge reconciliation and monitor adherence.
• Monitor open encounters to ensure chart closes per policies.
• Educate on annual coding updates and roll out new codes timely.
• Ensure codes dropped are correct for all services rendered.
• Support leaders on charge capture, documentation, and reimbursement initiatives.
• Collaborate with departments and vendors on coding alignment.

Skills

Coding

Auditing

Documentation

Communication

Education

Bachelor's Degree

Tools

EPIC Systems

Job description

Job Description The Opportunity

This is a tele-commuting position with a requirement to live in the Kansas City metro area due to some travel to area clinics as needed. The Revenue Integrity Analyst is responsible for improving charge capture accuracy through workflow assessments coding reviews process improvement collaboration and reporting. The Revenue Integrity Analyst works collaboratively with leadership to assist in development project management and implementation of process enhancements or corporation initiatives to enhance charge capture accuracy. In addition this role monitors and analyzes coding performance at the section and business unit levels. The Revenue Integrity Analyst serves as the liaison between revenue cycle operations IT and finance as it relates to charge capture documentation and reconciliation and possesses a clear understanding of the physician revenue cycle. The Analyst oversees understands and communicates departmental charging processes including the CDM charge linkages to the CDM and charging processes. The Analyst analyzes and communicates denial trends to providers and operational leaders. This position requires advanced knowledge in coding, auditing, and documentation guidelines. CPC or CCS and CPMA or CEMA is required. This position is a part of the Revenue Integrity Department and provides support to departments within the Revenue Cycle. The primary role of this position is to support education, documentation principals, clean claims, and denial prevention. This position is an exempt position. RIA would need to be available M-F during business hours. This is a telecommuting position, offers career ladder advancement opportunities, and includes a bonus program. 3 years’ experience as a coder and 2 years of experience in auditing/chart reviews. Revenue Integrity Objective: Support Physicians, APPs and other billable providers by providing education on documentation and coding to the highest level of service being rendered. Serves throughout the revenue cycle, operations, and IT as it relates to charge capture, charge accuracy, documentation, denial prevention, and charge reconciliation while maximizing revenue and compliance.

1. 1. Analyze and conduct regularly scheduled chart audits and education for Physicians, APPs and other billable providers by evaluating education needs from audit results as outlined in our policies.
2. 2. Analyze and conduct audits for focused requests such as internal reviews, program & payment integrity reviews, payor programs. Participate in facilitation of the process from time it is received to completion of request.
3. 3. Responsible for research and communication on regulatory requirements and payor policies that impact charging and reimbursement for the areas assigned.
4. 4. Identify education and improvement opportunities for accuracy, outliers and missed revenue by utilizing data such as: revenue, RVUs, denials, CPTs by specialty, lag days in documentation to provide education to operational leaders and Physicians, APPs and other billable providers.
5. 5. Train departments on charge reconciliation. Monitor to ensure the charge reconciliation is happening in the areas assigned.
6. 6. Monitor open encounters to ensure the chart is closing within the guidelines of the policies.
7. 7. Educate Physicians, APPs and other billable providers, practice leaders and revenue cycle on annual coding updates and drive necessary EPIC revisions. Work with leadership to roll out new codes as applicable and timely.
8. 8. Analyze and ensure codes dropping are correct for all services rendered outside of that coded by HIM.
9. 9. Support operational leaders on efforts and initiatives related to charge capture, documentation, and reimbursement items.
10. 10. Collaborate with other departments (MILs, CDI, CDS, HIM, Charge Mgmt) and vendors to research where shared responsibilities for coding alignment or impact is needed.

Why Saint Luke’s?

We are dedicated to innovation and always looking for ways to improve. We offer a Career Advancement Program to expand your skills and grow your career. We believe in creating a collaborative environment where all voices are heard. We are here for you and will support you in achieving your goals. Saint Luke’s offers competitive salaries and benefits packages to all of their employees,

• Saint Luke’s offers competitive salaries and benefits packages to all of their employees,

Job Requirements

1. Applicable Experience: 3-5 years Bachelor's Degree
2. Full Time Day (United States of America)

Job Details

Saint Luke’s Health System includes 18 hospitals and campuses across the Kansas City region, home care and hospice, behavioral health care, dozens of physician practices, a life care senior living community, and more.

Find out more about what Saint Luke’s offers: http://www.saintlukeskc.org/about-saint-lukes