Revenue Integrity Analyst

Intermountain Health; San Juan (PR); On-site; USD 4,272,000 - 14,029,000; Full time

Job summary

The RCO Revenue Integrity Analyst at Intermountain Health will support accurate charge capture, claim and charge edits, and revenue optimization for the assigned service line. You will analyze data, generate reports, and monitor trends to uphold regulatory compliance under the revenue practice leadership.

Strong collaboration with clinical operations and a focus on CMS/payor guidelines will be essential, as will attention to detail and data-driven problem solving.

Qualifications

• Demonstrated attention to detail with strong organizational and analytical skills.
• Flexibility and adaptability to change.
• Ability to work in a clinical operational area and revenue integrity team.
• Experience collaborating with a multidisciplinary team to optimize patient experience and operations.

Responsibilities

• Analyzes data, develops reports, reviews trends and recommends enhancements.
• Monitors CMS, federal and state regulations, payor guidelines for compliance and optimization.
• Provides education to revenue cycle and clinical operations on report development and revenue monitoring.
• Performs data mining and regulatory/payer policy review, abstracting financial/clinical information.

Skills

Data Mining

Healthcare regulations

Health Insurance

Medical terminology

Communication

Detail-orientated

Problem solving

Data Analysis

Excel

Collaboration

Education

Bachelor’s degree in Finance, Healthcare Management, Data Science, Health Information Management, or related field

Job description

Job Description

The RCO Revenue Integrity Analyst is responsible for appropriate charge capture, assigned account, claim edits and/or charge edits for an assigned service line. This position will support the maintenance of consistent charge capture or charge edits to ensure regulatory compliance and revenue optimization for assigned service line(s).

We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, Massachusetts, Minnesota, New York, Pennsylvania, Rhode Island, Virginia Vermont, Washington. Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings.

Video phone screens and interview(s) through Microsoft Teams will be required as well for fully remote position.

Essential Functions

• Analyzes data, develops reports, reviews trends and recommend enhancements as defined by the revenue practice leadership team.
• Participates, researches and follows-up on topics presented at department and system-wide initiatives.
• Monitors for positive or negative trends in coding, charge capture and/or editing processes to improve teams' performance. Researches and stays current on CMS, federal and state regulations, payor guidelines, ensuring compliance and alignment with charge, coding and charge edits.
• Provides education and guidance to revenue cycle and clinical operations on report development, charge capture accountability and revenue monitoring.
• Performs extensive data mining, regulatory and payer policy review, abstracting of financial and clinical information from various sources

Skills

• Data Mining
• Healthcare regulations
• Health Insurance
• Medical terminology
• Communication
• Detail-orientated
• Problem solving
• Data Analysis
• Excel
• Collaboration

Qualifications

Required

• Demonstrated experience in a role requiring attention to detail with excellent organizational and analytical skills.
• Demonstrates flexibility and adaptability to change.
• Demonstrates ability to work in a clinical operational area and/or a revenue integrity team effectively supporting department outcomes.
• Experience working closely with a multi-disciplinary team to optimize patient experience and operational success.

Strongly preferred

• Epic proficiency or certification in relevant clinical, coding, or billing applications.
• Experience with hospital and/or facility billing processes, charge capture, coding compliance, and revenue cycle operations.
• Demonstrated experience analyzing coding, billing, reimbursement, and payer requirements within a healthcare environment.
• Bachelor’s degree in Finance, Healthcare Management, Data Science, Health Information Management, or a related field. Education is verified.
• Demonstrated clinical or healthcare revenue cycle experience.

Physical Requirements

• Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
• Frequent interactions with providers, colleagues, customers, patients/clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.

Location

Lake Park Building

Work City

West Valley City

Work State

Utah

Scheduled Weekly Hours

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$31.01 - $48.84

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here (https://intermountainhealthcare.org/careers/benefits) .

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.

Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery.

Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment.

Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment. Learn more. (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/peak-program/)

The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor.

Thanks for your interest in continuing your career with our team!