*Revenue Integrity Analyst-Payment Variance& Resolution/Full Time/Hybrid

Henry Ford Health; Troy (MI); On-site; USD 65,000 - 85,000; Full time

Job summary

A healthcare organization is seeking an RI Analyst for Payment Variance and Resolution. This role requires a Bachelor's degree in a relevant field or extensive experience in Healthcare Revenue Cycle. Responsibilities include managing underpayment recovery strategies and collaborating with multidisciplinary teams to enhance revenue protection. Excellent analytical, communication, and interpersonal skills are necessary. The ideal candidate should also be familiar with Medicare and Medicaid billing rules, and EPIC experience is preferred.

Qualifications

• Bachelor's required or 7+ years of experience in relevant fields.
• Outstanding analytical and communication skills required.
• Knowledge of Medicare and Medicaid reimbursement rules essential.

Responsibilities

• Manage underpayment recovery strategies to maximize reimbursements.
• Collaborate with multi-disciplinary teams to improve efficiencies.
• Analyze payment variances and trends from HFHS payers.

Skills

Analytical skills

Communication skills

Interpersonal skills

Decision making

Collaboration skills

Diplomacy skills

Education

Bachelor's degree in Business Administration, Healthcare, Finance, or IT

7+ years of experience in Healthcare Revenue Cycle

1-2 years in a Healthcare or Business setting

Tools

EPIC

Microsoft Office, particularly Excel

Job description

General Summary

Reporting to the Manager, Payment Variance and Resolution, the RI Analyst, Payment Variance and Resolution is responsible for maintenance of underpayment recovery strategies and systems designed to facilitate and maximize reimbursement for HFHS hospitals, provider, and ambulatory revenue cycle operations. Revenue Integrity (RI) is a distinct function that drives proactive charge capture opportunity identification and realization, provides focus toward revenue protection and maintenance, and identification of individual underpayments and underpayment trends from HFHS payers. Project work may include technical analyses or may require participation in a large multi-disciplinary group of administrators and/or physician leaders, including collaboration with Reimbursement, System Contracting and Contract Modeling team members and HFHS payers. Works collaboratively with leadership to increase efficiencies, reduce variability, reduce errors/defects, reduce organizational and compliance risk and involve all appropriate Revenue Cycle team members.

Education/Experience Required

• Bachelor's in Business Administration, Healthcare, Finance, IT, or related field, or seven (7) or more years of experience in Hospital or Professional Billing, Contracting, Payment Variances, or other Healthcare Revenue Cycle experience required.
• Outstanding analytical, communication and interpersonal skills are required.
• Minimum of one to two (1-2) years in a Healthcare or Business setting.
• Knowledge of Medicare, Medicaid, Medicaid OPPS reimbursement, and other third-party billing rules/coverage are required.
• EPIC experience preferred.
• Excellent oral and written communication skills. Excellent analytical, motivational, and critical thinking skills.
• Ability to manage large, complex, simultaneous assignments with potentially conflicting priorities and deadlines.
• Sound decision making skills.
• Strong diplomacy and collaboration skills.
• Strong knowledge of Microsoft Office, particularly Excel.
• Strong, growing base of analytical/technical, facilitative and process improvement knowledge. Has experience in gathering and organizing data from disparate sources and presenting findings to leadership in a way that is useful for decision support, benchmarking, and quality performance tracking.

Additional Information

• Organization: Corporate Services
• Department: Revenue Integrity
• Shift: Day Job
• Union Code: Not Applicable