RN Revenue Integrity Analyst: Drive Accurate Charging & Coding

Mercy Health Corporation; Janesville (WI); On-site; USD 75,000 - 112,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Life & Disability Insurance

Paid time off

Job summary

Mercy Health Corporation seeks an experienced Revenue Integrity professional to partner with clinical leaders and ensure accurate charge capture, coding, and billing practices across service lines. The role includes evaluating charging processes, guiding staff on CPT/HCPCS usage, and monitoring EPIC dashboards in a day shift, 40 hours per week.

The candidate should have RN licensure, a BSN, 3+ years in revenue cycle, and experience with hospital coding/revenue integrity projects.

Qualifications

• Bachelor of Science in Nursing degree and +three (3) years of experience within the revenue cycle.
• Experience above minimum requirement will be considered in lieu of education.
• Experience: In excess of five (5) years' experience in the hospital setting, healthcare industry or coding with a focus in one or more of the following areas: charge integrity; charge reconciliation; charge compliance; charge auditing; hospital leadership.
• Knowledge of CPT/HCPCS procedural coding preferred.

Responsibilities

• Interacts with clinical department directors to monitor charge capture functions across all entities.
• Evaluates current charging and coding structures and processes in clinical departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements.
• 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.
• Advises service line leaders and their staff on proper usage of charge codes; identifies opportunities for capturing additional revenue in accordance with payer guidelines; develops specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.
• Provides guidance and communication on correct change capture, coding and billing processes to clinical departments and facilities.
• Monitors EPIC Revenue Integrity Dashboard(s)
• Participates in moderately complex projects related to revenue integrity initiatives.
• Provide support for assigned cost centers within service lines
• Participates in analyzing changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars and publications.
• Train and assist clinical team with revenue integrity functions.
• Performs miscellaneous duties as assigned.

Skills

Analytical skills

Communication skills

Revenue cycle knowledge

Project management

Education

BSN in Nursing

Tools

EPIC HB/PB

CPT/HCPCS coding

Job description

Mercy Health Corporation seeks an experienced Revenue Integrity professional to partner with clinical leaders and ensure accurate charge capture, coding, and billing practices across service lines. The role includes evaluating charging processes, guiding staff on CPT/HCPCS usage, and monitoring EPIC dashboards in a day shift, 40 hours per week.

The candidate should have RN licensure, a BSN, 3+ years in revenue cycle, and experience with hospital coding/revenue integrity projects.