Revenue Integrity Analyst Sr.

Northside Hospital; Atlanta (GA); On-site; USD 95,000 - 130,000; Full time

Job summary

Northside Hospital is seeking a Chargemaster/Revenue Integrity professional to lead design and maintenance of chargemaster, ensuring regulatory compliance and proper coding practices. You will educate managers, coordinate new department set ups, and drive audits across the revenue cycle.

Ideal candidates have 5+ years in hospital chargemaster roles, relevant nursing or HIM credentials, and strong communication skills.

Qualifications

• Bachelor-level degree in Nursing/HIM/Healthcare Administration or Business Administration; or Associates with 8 years hospital charge master experience.
• Must have a coding or nursing credential (RHIA, RHIT, CCS, RN) or a financial background.
• Minimum of 5 years hospital Charge Master experience.
• Demonstrated communication skills and ability to work independently with diverse staff.
• Knowledge of Microsoft Office products.

Responsibilities

• Reviews compliance regulations and coding requirements (primarily Medicare) and updates the Chargemaster accordingly.
• Educates Department Managers on compliance and coding regulations.
• Coordinates with Department Managers on new procedures to ensure charges are set up in the Chargemaster and staff are trained.
• Coordinates Chargemaster setup for new Departments.
• Assists in developing Hospital System Policies related to charge entry and pricing.
• Conducts audits to ensure charges are captured and coded correctly.
• Collaborates with the business office to resolve denial issues related to Chargemaster.
• Provides guidance and mentoring to Revenue Integrity Analysts and Coding Analysts.
• Monitors revenue by analyzing charge lag, late charges, denials, and wRVU volumes.
• Collaborates with Northside departments and leadership on revenue cycle improvement.
• Assists Revenue Integrity Coordinator in other projects and analyses.

Skills

Regulatory compliance

Coding regulations (Medicare)

Leadership

Communication skills

Microsoft Office

Education

Bachelor-level degree in Nursing/ HIM/ Healthcare Administration/ Business Admin

Associates degree with 8 years charge master experience

RHIA/RHIT/CCS/RN credential

Job description

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

Independently develops strategies, design solutions and establishes processes which contribute to team collaboration and department satisfaction. Focus on charge master set up and maintenance to comply with federal, state and hospital regulations in addition to monitoring charge activities and compliance. Identifies trends, collaboratively works with leadership to help improve the revenue cycle performance within the hospital and/or Ambulatory Clinics.

PRIMARY DUTIES AND RESPONSIBILITIES

1. Reviews compliance regulations and coding requirements (primarily Medicare) and incorporates these changes into the Chargemaster.
2. Autonomously educates Department Managers on compliance and coding regulations.
3. Independently coordinates with Department Managers on new procedures being performed to assure the charges are set up appropriately and timely in the Chargemaster and the staff responsible for entering charges are educated.
4. Coordinates the set-up of Chargemasters for new Departments.
5. Assists in the development of Hospital System Policies relating to charge entry, price setting, and developing new charge items.
6. Conducts audits to ensure all documented charges are captured appropriately and timely and performs audits to review the charges are being coded correctly.
7. Coordinates with the business office to resolve any denial issues related to the Chargemaster.
8. Provides guidance, support and mentoring to Revenue Integrity Analysts and Coding Analysts.
9. Monitors revenue by trending, troubleshooting and analyzing data such as charge lag, late charges, denials and/or wRVU volumes.
10. Collaborate with other Northside departments and leadership as it relates to the revenue cycle and betterment of Northside
11. Assists Revenue Integrity Coordinator in other projects and analyses.

REQUIRED

1. B.S. degree in Nursing, Health Information Management, Healthcare Administration or Business Administration; or Associates Degree with 8 years of hospital charge master experience in lieu of a bachelor's degree.
2. Must have a coding or nursing credential (RHIA, RHIT, CCS, RN) or a financial background.
3. Must have minimum of 5 years hospital Charge master experience.
4. Demonstrated communication skills and an ability to work independently and deal effectively with various types of personnel.
5. Knowledge of Microsoft Office products.
6. Self-Motivated leader with a collaborative mindset, driven to take initiative and build the department's reputation of quality service.

PREFERRED

1. Three to five years Chargemaster experience in a hospital setting.