Revenue Integrity Analyst II

Intermountain Healthcare; United States; Remote; Full time

Job summary

A leading healthcare organization is seeking a Revenue Integrity Analyst II responsible for billing and resolving payment issues. The role requires analytical skills and experience in revenue cycle operations, with a focus on compliance and quality. Candidates should have an Associate's Degree or relevant certifications, and will work in a collaborative environment to enhance revenue capture and ensure adherence to regulations.

Benefits

Comprehensive benefits package

Qualifications

• Associates Degree or two years of leading projects/teams.
• Certified Revenue Cycle Representative (CRCR) certification within 3 months of hire.
• Three years of experience in revenue cycle operations.

Responsibilities

• Analyze data and develop reports to identify trends.
• Ensure compliance with CMS, Federal, State regulations.
• Provide education and guidance on charging/coding regulations.

Skills

Attention to detail

Problem-solving

Communication

Teamwork

Education

Associates Degree in a healthcare-related field

Bachelor's Degree (preferred)

Tools

EPIC

Word

Excel

Job description

Job Description:

This position is responsible for billing, follow-up, and resolving issues that delay or prevent payment of the patient's account within Intermountain's policies and procedures.

Revenue Integrity Analyst II

1. Analyze data, develop reports, review trends, and recommend enhancements as defined by the RI leadership team. Proactively seek out positive or negative trends in charge/coding capture and editing processes to facilitate the sharing of best practices and performance improvement opportunities.
2. Understand and assist in other areas of the revenue cycle to support the quality and compliance of charges and documentation.
3. Participate, research, and follow-up on topics presented at department and system-wide initiatives, including audits and reviews for government, commercial, and third-party payers.
4. Monitor the status of RI activities using a defined tracking system, ensuring timely responses. Assist in determining appropriate responses and activities in collaboration with involved parties including care site teams, external partners/vendors, compliance, legal, health information management, and other relevant areas.
5. Assist the manager with interviews, onboarding, monitoring, goal setting, annual reviews, and metric design activities. Coordinate and oversee orientation and training for new and existing associates and partners, validate competency, and perform retraining as needed. Oversee productivity, vacation coverage, and work assignments.
6. Stay current in specific areas of focus. Provide education and guidance to service line leadership, providers, and frontline staff regarding updates to charging/coding/NCCI regulations, errors, audits, and appeals to facilitate corrective actions.
7. Ensure compliance with CMS, Federal, State regulations, and payor guidelines. Incorporate regulation updates into workflows to ensure accurate revenue capture and compliance.
8. Validate that documentation supports charges, and that charges and coding are aligned with procedures and guidelines, ensuring timely and accurate revenue capture for designated service lines.
9. Act as a subject matter expert within the team and escalate issues to leadership as needed. Support systems like Epic and downstream functionalities.
10. Promote the mission, vision, and values of SCL Health and adhere to service behavior standards.
11. Perform other duties as assigned.

Minimum Qualifications:

• Associates Degree in a healthcare-related field or two (2) years of experience leading projects or teams.
• Certified Revenue Cycle Representative (CRCR) certification within 3 months of hire.
• One of the following certifications: AAPC or AHIMA coder certification, or HFMA.
• Three (3) years of relevant experience in revenue cycle operations in an acute or medical office setting.

Preferred Qualifications:

• Bachelor's Degree (preferred).
• Proficiency in EPIC (preferred).
• Experience as an educator, preceptor, or trainer (preferred).
• Knowledge of CMS Guidelines (Medicare/Medicaid).

Additional Requirements:

Ability to perform essential duties satisfactorily, including attendance, communication, attention to detail, problem-solving, teamwork, basic math, and proficiency in Word and Excel. Experience in collaboration and communication with staff and leadership is required.

Physical Requirements:

Effective communication, operating computers and office equipment, reading monitors/documents, sitting or standing for long periods, lifting, bending, kneeling, and reaching.

Location & Schedule:

Lake Park Building, West Valley City, Utah. 40 hours/week. Hourly rate: $32.77 - $51.61.

Benefits & Equal Opportunity:

Comprehensive benefits package. Intermountain Health is an equal opportunity employer. We use AI platform HiredScore for application review, with final hiring decisions made by Intermountain staff. All positions are subject to closing without notice.