Revenue Integrity Analyst, Epic Revenue Cycle Analyst, Mt. Laurel

Jobtome; Mount Laurel Township (NJ); Hybrid; USD 75,000 - 100,000; Full time

Job summary

Jobtome is seeking a Revenue Cycle Analytics professional in New Jersey to lead audits and root-cause analyses within an Epic-based EMR environment. You will review charge master and fee schedules, ensure compliance with government policies and payer requirements, and collaborate across Revenue Integrity, Finance, IT and Clinical Operations.

You will monitor Epic work queues, analyze denials, and support pricing strategies to optimize reimbursement, while contributing to reporting and

Qualifications

• 3 to 5 years' experience within a large hospital or integrated healthcare delivery system.
• EPIC Revenue Integrity and Hospital/Physician Billing experience.
• Knowledge of CPT changes and regulatory updates and how they affect charge master and fee schedules.
• Ability to perform audits and root-cause analysis within Revenue Cycle.

Responsibilities

• Perform quantitative and financial analysis along with audits to identify opportunities for improvement across Revenue Cycle.
• Review and ensure charge master and fee schedules comply with government policies and third-party payor requirements; analyze CPT changes and regulatory updates.
• Collaborate with Revenue Integrity, Finance, IT and Clinical Operations to perform deep-dive reviews and identify trends and corrective actions.
• Monitor and analyze Revenue Cycle work queues in Epic; identify issues, trends, root causes, and develop action plans.
• Assist in strategic pricing to optimize reimbursement within budget guidelines and help resolve Revenue Cycle issues.
• Assist with Epic performance reporting including Revenue & Usage, Enterprise Charge Reconciliation and Volume reports.
• Serve as a resource to Patient Financial Services staff for denials and coding issues; recommend solutions to account representatives.

Skills

Collaboration across disciplines

Oral & written communication

Interpersonal skills

Presentation skills

Prioritization & planning

Analytical thinking

Education

Bachelor's degree in Accounting or Finance

Tools

EPIC

Job description

The following experience is strongly preferred:

• *EPIC
• *Hospital charge description master experience
• *Charge audits
• *Coding & billing guidelines

Schedule:

Monday-Friday 8:30am - 5:00pm

First 90 days, Monday through Thursday onsite, and Friday remote.

Upon successful training, hybrid 2 days onsite and 3 days remote.

Local onsite meeting requirements.

Job Summary:

The position is responsible for root cause analytics along with audits to help identify opportunities, issues, and process improvement within the Revenue Cycle. This role supports the revenue cycle workflows, charge capture, work queue and denial review processes within an Epic based EMR.

This position will help optimize Revenue Cycle by evaluating, validating and trending data for presentation to all levels of the organization. Will support the Virtua Hospitals, Physician Groups and Home Health.

Position Responsibilities:

Perform quantitative and financial analysis along with audits designed to identify opportunities for improvement across the full spectrum of the Revenue Cycle.

Assists in ensuring that the charge master and fee schedules are in accordance with government compliance policies and procedures, as well as third party payor needs. Review, identify, and analyze necessary CPT changes related to quarterly and annual AMA CPT updates and regulatory changes by timelines set. Works with revenue producing departments to ensure the ongoing coordinated consistency of the charge master and fee schedules, including accurate descriptions, coding, additions, deletions, pricing, and any other changes. Conduct analytical reviews determine net revenue effect of proposed charge master and fee schedule changes. Perform internal billing audits to ensure correcting coding/billing regulatory compliance and charge capture accuracy.

Incumbent must develop close working relationships with management and staff in Revenue Integrity, Finance, Information Technology and Revenue and Clinical Operations allowing them to perform deep-dive analysis and reviews assisting with the identification of trends, solutions and potential corrective action steps. Will work both independently and have a high level of self-directed work efforts as well as be an integral part of the Revenue Integrity Team. Revenue Cycle will include areas from Hospital, Physician and Home Health.

Monitor and assists with review of revenue cycle work queues in Epic. Perform analysis to identify issues, trending, root cause, and action plan development with work queue issues.

Assist in strategic pricing process to optimize reimbursement within budget guidelines. Participate in ongoing coordination and resolution of revenue issues as they arise. Assists in troubleshooting and resolving issues related to the patient revenue cycle and assists in development and recommendations.

Provide guidance and communication and collaborate with Revenue Integrity Team, Clinical Operations and IT to help ensure work queue rules are accurate and updated based on annual and quarterly coding changes.

Assist with Epic performance reporting, including assisting with Revenue & Usage, Enterprise Charge Reconciliation and Volume Reports. Work queue and reporting will include areas from Hospital, Physician and Home Health.

Serve as resource to Patient Financial Services staff for reporting problems and denials on individual claims. Assist in researching coding issues, provide guidance and recommend solution to account representative.

Analyze billing errors and denial data to identify root cause of issues. Work with Revenue Integrity Team, Clinical Operations and Patient Financial Services staff to implement corrective actions to ensure compliant charges, prevent future rejections/denials and accurate and reimbursement. Claim issues and denials will include areas from Hospital, Physician and Home Health.

Lead and participate in projects related to Revenue Cycle initiatives. Participate in ongoing coordination and resolution of revenue issues as they arise. Provide input to Director and Manager for annual Revenue Integrity planning process. Assist with additional projects as needed for Hospital, Physician and Home Health.

Position Qualifications Required:

Required Experience:

3 to 5 years' experience within a large hospital or integrated healthcare delivery system.

• Ability to work collaboratively across disciplines and business lines.
• Exceptional oral/written communication skills and highly customer focused.
• Excellent interpersonal and presentation skills.
• Able to communicate with many, various customers.
• Ability to prioritize, plan and execute.
• Excellent critical thinking, analytical skills.

Required Education:

Bachelor's degree, in Accounting, Finance, Healthcare preferred

Training / Certification / Licensure:

EPIC Revenue Integrity, Hospital Billing, Physician Billing Certification, preferred #RD_P1