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

Virtua Health; Mount Laurel Township (NJ); Hybrid; USD 71,000 - 110,000; Full time

Job summary

Virtua Health is seeking a Revenue Integrity Analyst to perform root cause analytics and audits within the Revenue Cycle, supporting an Epic-based EMR across Virtua Hospitals, Physician Groups and Home Health.

The role analyzes data to identify opportunities, validates charge capture, and ensures compliance with government and payer requirements, collaborating with Revenue Integrity, Finance, IT and Clinical Operations for improvements and reporting.

Qualifications

• 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.

Responsibilities

• Perform quantitative and financial analysis along with audits 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, ...

Skills

Cross-functional collaboration

Oral & written communication

Interpersonal skills

Prioritization

Analytical thinking

Education

Bachelor's degree in Accounting, Finance, or Healthcare

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, ...

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

Salary

$70,935 - $110,268 Yearly

Benefits

Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies.