Senior Revenue Integrity Analyst - Charge Master & Coding

Northwestern Medicine Central DuPage Hospital; Warrenville (IL); On-site; USD 55,000 - 80,000; Full time

Benefits offered by this job

Tuition Reimbursement

Student Loan Repayment

Professional Development

Wellbeing Fund

401(k) Matching

Medical/Dental/Vision Coverage

Life Insurance

Annual Salary Increase and Incentive

PTO & Holidays

Job summary

Northwestern Medicine Central DuPage Hospital in Warrenville, IL is seeking a Senior Revenue Integrity Analyst to support the Clinical Department and revenue cycle. You will perform charge capture analysis, maintain the charge master for accuracy, and prepare analyses for management and clinical departments.

The role requires 5+ years in revenue cycle or revenue integrity, strong knowledge of CPT/HCPCS/ICD-10, and EPIC skills.

Qualifications

• Proficiency with Microsoft Office suite.
• 5+ years in revenue cycle or revenue integrity role.
• Advanced understanding of CPT, HCPCS, ICD-10, and third party billing requirements.
• Extensive knowledge and experience with Medicare/Medicaid regulations.

Responsibilities

• Perform daily maintenance and quarterly audits of the EAP.
• Prepare necessary files for the EAP database of required department builds.
• Proactively identify charge capture opportunities in all revenue producing departments.
• Research and interpret billing and coding regulations, communicate to impacted areas, and apply changes that affect policy, financial, charge capture, patient care, billing, and coding operations.
• Lead quarterly audits on the charge master data elements.
• Review departmental front-end charge capture tools for accuracy.
• Leads complex audits and prepares methodology for annual pricing changes and/or annual coding changes.
• Consistently delivers concrete, relevant results. Displays qualities of resiliency and resourcefulness while thinking strategically and practically when problem solving. In addition to results orientation, displays business knowledge, speed and decisiveness, and project management.
• Troubleshoot complex account errors and provides education for resolution to Revenue Manager(s).
• Resolve and answers questions related to charge capture and complex regulatory billing issues. (e.g. Provider-Base status rules, OPPS, CCI, MUE).
• Liaison with Revenue Cycle, IT and clinical departments to link EPIC and charge master.
• Research, compile, and analyze financial data while organizing and maintaining database files for financial modeling.
• Mentors and supports members of Revenue Integrity Team as an informal leader.
• Lead efforts to assess, modify, and/or develop and implement more timely and consistent processes/systems to increase efficiency, accuracy, and meaningfulness of information.
• Demonstrates knowledge in computer applications such as knowledge in databases, spreadsheets and word processing applications in a high complexity environment.
• Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, adopting and implementing industry best practices, and participating in professional societies.
• Supports the finance, operations and revenue cycle teams through special projects.
• Protect operations by keeping financial and patient information confidential.
• Supports the finance operation of Northwestern Medicine.

Skills

Strong communication

Analytical skills

Collaboration

Attention to detail

Education

Bachelor’s Degree in Business or related field

10 years of equivalent experience

Tools

EPIC Certification (Resolute Charge Capture)

EPIC Certification (Clarity Report Data)

SQL

Job description

Northwestern Medicine Central DuPage Hospital in Warrenville, IL is seeking a Senior Revenue Integrity Analyst to support the Clinical Department and revenue cycle. You will perform charge capture analysis, maintain the charge master for accuracy, and prepare analyses for management and clinical departments.

The role requires 5+ years in revenue cycle or revenue integrity, strong knowledge of CPT/HCPCS/ICD-10, and EPIC skills.