Revenue Integrity Analyst II-1

Jefferson Health Plans; Philadelphia (Philadelphia County); Sur place; USD 70 000 - 90 000; Plein temps

Résumé du poste

Jefferson Health Plans seeks a Revenue Integrity Analyst II-1 in Philadelphia to improve the accuracy and integrity of patient charges and ensure compliant billing practices. You will partner with Revenue Cycle and clinical teams to monitor payer regulations, coding and billing guidelines, and train staff on charge workflows.

This role requires strong analytical skills and a solid understanding of charge capture, denials management, and regulatory updates.

Qualifications

• Improve the accuracy and integrity of patient charges and ensure compliant billing practices.
• Collaborate with Revenue Cycle and clinical departments to monitor payer regulations, coding and billing guidelines.

Responsabilités

• Interacts with co-workers, visitors, and other staff consistent with Jefferson values.
• Primary clinical service-line liaison regarding payor guidelines and explaining regulatory requirements.
• Serves as the subject matter expert for clinical departments on revenue cycle issues.
• Identifies charge edit trends based on documentation, coding or charging issues and recommends workflow opportunities.
• Completes focused charge review assessments for assigned clinical departments and/or service lines to ensure charges are accurate.

Description du poste

Number of Positions In Requisition

1

Job Details

Revenue Integrity Analyst II-1

Job Description

PRIMARY FUNCTION :

Works to improve the accuracy, integrity and quality of patient charges and to ensure minimal variation in charging practices. Responsible for collaborating with Revenue Cycle and clinical departments to ensure accurate and thorough high level analysis of governmental and commercial payer regulations related authorization, coding and billing guidelines. Maintains current knowledge regarding coding guidelines, changing/billing regulations and regulatory agency activities.

ESSENTIAL FUNCTIONS:

Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.

Primary clinical service-line liaison regarding payor guidelines, explaining regulatory requirements, and ensuring accountability and solid charge workflows for revenue integrity.

Serves as the subject matter expert for clinical departments on issues related to revenue cycle.

• Identifies charge edit trends based on documentation, coding or charging issues and recommends workflow opportunities.
• Completes focused charge review assessments for assigned clinical departments and/or service lines to ensure