Senior Revenue Integrity Analyst

Dayton Children's Hospital; Rome (OH); Hybrid; USD 75,000 - 95,000; Full time

Job summary

Dayton Children's Hospital is looking for a Senior Revenue Integrity Analyst to oversee and ensure accurate billing in their Revenue Integrity Services department. The role involves planning and maintaining workflows and compliance with regulatory changes.

The ideal candidate will have a Bachelor’s degree in Health Information Management or Finance, along with 6-10 years of experience in revenue integrity analysis in healthcare. Familiarity with Epic and certification in CDM Management are essential.

Qualifications

• 6-10 years of revenue integrity analysis experience in healthcare.
• EPIC CDM/Revenue Integrity certification within 6 months of employment required.
• Experience with CPT and HCPCS codes.

Responsibilities

• Establish and enforce the hospital’s pricing and coding.
• Maintain work queues and understand yearly regulatory changes.
• Coordinate with various departments for operational support.

Skills

Revenue integrity analysis

CPT code research

Microsoft Office proficiency

Education

Bachelor’s degree in Health Information Management or Finance

Master’s degree

Tools

Epic electronic health record

Trisus (Craneware)

Strata

Job description

Job Details

The senior revenue integrity analyst is responsible for planning and oversight of the revenue integrity analysts’ performance of essential department accountabilities, including reporting to department leadership about goal status. This position will be responsible for all aspects related to revenue integrity, including maintaining work queues, understanding and applying yearly regulatory changes, maintaining the chargemaster, and preventing revenue leakage. The senior revenue integrity analyst works accounts in assigned Revenue Integrity work queues to facilitate accurate, compliant billing of patient accounts and assists revenue integrity analysts with completion of tasks and work queues. The position must be certified in Epic CDM Management/Revenue Integrity to create, edit, delete and research various CDM requests for all hospital departments for both hospital and professional billing.

Responsibilities

The senior analyst is responsible for establishing and enforcing the hospital’s pricing, coding, and regulatory changes. The incumbent must understand how billing and the CDM interact for chargemaster build, assist in hospital decision making related to chargemaster requests, and provide operational analytical support with regards to reimbursement, charge lag, revenue trends, and other revenue related items. The senior revenue integrity analyst will coordinate and collaborate these actions with, but not limited to, Health Information Management, Information Systems, Billing, Finance and Operations.

Facility

Work from Home - Hybrid - Ohio

Department

Revenue Integrity Services

Schedule

Full time

Hours

40

Education

• Bachelor’s degree in Health Information Management, Finance or related field required
• Master’s preferred

Experience Required

• 6-10 years of revenue integrity analysis experience in healthcare
• Experience with EPIC electronic health record
• EPIC CDM/Revenue Integrity certification within 6 months of employment required
• Ability to research CPT and regulatory requirements
• Experience with CPT and HCPCS codes and interpreting CPT guidance
• Experience in healthcare billing, CMS Medicare and Medicaid reimbursement methodologies
• Proficiency in Microsoft Office Tools (Outlook, Excel)

Preferred Qualifications/skills

• Trisus (Craneware) chargemaster experience
• Strata experience
• Registered Health Information Administrator (RHIA) Certification