Revenue Integrity Analyst II - Charge Master Expert

Health Partners Plans; Philadelphia (Philadelphia County); On-site; USD 75,000 - 110,000; Full time

Job summary

Thomas Jefferson University in Philadelphia is seeking a Revenue Integrity Analyst II-1 to improve charge accuracy and integrity across payer regulations. The role collaborates with Revenue Cycle and clinical departments to analyze coding and billing guidelines and to ensure compliant, high-quality charge capture.

The position involves serving as a subject matter expert for revenue cycle issues, identifying charging trends, and advising on optimal charge codes to maximize compliant revenue.

Qualifications

• Bachelor's or Associate's degree in Health Information Management, Business Administration, Accounting, Management, Healthcare Administration.
• RHIA, RHIT, CCS, or CPC credentials required; AAHAM or HFMA preferred.
• Five years experience in a hospital setting or healthcare strongly preferred.
• 1–3 years auditing and/or coding experience required.
• Knowledge of Medicare/Medicaid regulations, including billing, coding and documentation.
• Understanding of IPPS, OPPS and fee schedule.
• Strong oral and written communication skills.
• Excellent organizational and project management skills.

Responsibilities

• 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 that charges are generated in accordance with established policies and timeframes.
• Serves as the service-line liaison between Revenue Cycle and clinical department administration regarding revenue, regulatory, coding, billing and charge capture matters.
• Develops processes to modify existing chargemaster review applications to reduce charge-related claim edits/rejections.
• Advises service-line leaders and staff on proper usage of charge codes; identifies opportunities for capturing additional revenue per payer guidelines.
• Reviews Charge Description Master change requests for accuracy and appropriateness; approves additions, deletions, and modifications to charges.
• Prepares revenue cycle meeting materials and facilitates clinical service-line Revenue Cycle department meetings.
• Collaborates with clinical department personnel to analyze Charge Description Master billing processes and identify root causes for claims issues/rejections; investigates complex issues as necessary; makes recommendations for solutions to management.
• Assists in the development and implementation of effective chargemaster review, education and training.

Skills

Communication

Project management

Time management

Mentoring

Education

Bachelor's or Associate's degree in Health Information Management, Business Administration, Accounting, Management, Healthcare Administration

Job description

Thomas Jefferson University in Philadelphia is seeking a Revenue Integrity Analyst II-1 to improve charge accuracy and integrity across payer regulations. The role collaborates with Revenue Cycle and clinical departments to analyze coding and billing guidelines and to ensure compliant, high-quality charge capture.

The position involves serving as a subject matter expert for revenue cycle issues, identifying charging trends, and advising on optimal charge codes to maximize compliant revenue.