Revenue Integrity Analyst

Sentara Healthcare Inc; Norfolk (VA); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a Revenue Integrity Analyst to enhance revenue results through a comprehensive view of clinical and financial processes. This fully remote role emphasizes strong analytical and communication skills, requiring a proactive approach to revenue cycle management. The analyst will collaborate with various departments, ensuring compliance and accuracy in billing processes while participating in significant projects. Join a dynamic team dedicated to improving healthcare outcomes and enjoy a range of employee benefits, including medical insurance and opportunities for professional growth.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Paid Annual Leave

Sick Leave

Flexible Spending Accounts

Retirement Funds with Matching Contribution

Supplemental Insurance Policies

Work Perks Program

Opportunities for Advancement

Qualifications

• Bachelor's degree required with 3 years of healthcare-related experience.
• Advanced proficiency in Microsoft Office, especially Excel.

Responsibilities

• Perform reviews and updates related to Charge Description Master integrity.
• Analyze changes to coding and billing rules and regulations.

Skills

Healthcare Experience

Analytical Skills

Communication Skills

Financial Management Skills

Knowledge of CPT/HCPCS Codes

Education

Bachelor's Degree in Healthcare Administration

Bachelor's Degree in Accounting

Bachelor's Degree in Finance

Tools

Microsoft Office Suite

EPIC P/R

Craneware (Chargemaster Toolkit)

Job description

Sentara Healthcare is currently seeking an experienced professional to join our team as a Revenue Integrity Analyst---Remote

* This is a 100% Remote position for residents of the following approved states:

• Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, North Carolina, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming

Minimum Requirements:

• Bachelor Level Degree or previous related experience in lieu of Degree
• 2-3 years of healthcare experience with Degree
• Experience with Revenue Cycle.

Reporting to the Revenue Integrity Manager, the Revenue Integrity Analyst plays an important role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions, and interdependencies from the provision of patient care to final bill generation. Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, and superb analytic and organizational skills.

Job Responsibilities:

• With responsibility for all cost centers within service lines and acting with a high degree of autonomy, performs reviews and makes updates related to Charge Description Master (CDM) integrity.
• Evaluates current charging processes to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements, to ensure consistency across all entities.
• Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications.
• Assesses the accuracy of all charging vehicles, including Epic and ancillary clinical systems and dictionaries, encounter forms, and other charge documents.
• Provides guidance, communication, and education on correct charge capture, coding, and billing processes to multiple clinical departments and entities.
• Participates in complex projects related to revenue cycle initiatives.
• Collaborates with Revenue Operations, Compliance, Budget Offices, Patient Accounts, Health Information Services, Internal Audit, and other Revenue and Finance departments on revenue management initiatives, across all entities.
• Develops, maintains, and implements Revenue Integrity and CDM Management policies, procedures, and training materials.
• Work and analyze billing error and denial data to identify root causes. Executes work plans to correct identified deficiencies.
• Serves as subject matter expert (SME) of Epic charge capture methodologies and helps investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff.
• Prepare monthly and year-to-date statistical reports using analytical tools to exemplify findings and ensure accurate financial reporting.
• Participate in various special projects such as quarterly and annual CPT/HCPCS changes, annual pricing updates, and other related projects and duties as assigned.

Job Requirements:

• Bachelor’s degree required preferably in Healthcare Administration, Accounting, Finance, or a related field.
• Three years of healthcare-related experience
• Requires advanced proficiency in Microsoft Office Suite, especially in MS Excel. Experience with EPIC P/R and Craneware (Chargemaster Toolkit/Online Reference Toolkit) is a plus.
• Financial management skills, including the ability to financially analyze data for operations to provide guidance to department managers
• Knowledge of CPT/ HCPCS codes and Revenue Codes. Understanding of revenue integrity processes and their impact throughout the revenue cycle. Must demonstrate excellent communication skills including oral and written comprehension and expression.

As the third-largest employer in Virginia, Sentara Healthcare was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to:

• Medical, Dental, and Vision Insurance
• Paid Annual Leave, Sick Leave
• Flexible Spending Accounts
• Retirement funds with matching contribution
• Supplemental insurance policies, including legal, Life Insurance and AD&D among others
• Work Perks program including discounted movie and theme park tickets among other great deals
• Opportunities for further advancement within our organization

Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For