Senior Revenue Integrity Analyst, Procedural Governance

Northwestern Medicine; Warrenville (IL); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Tuition reimbursement

Loan forgiveness

401(k) matching

Lifecycle benefits

Job summary

Northwestern Medicine in Illinois is seeking a Senior Revenue Integrity Analyst to support the Clinical Department and revenue cycle with charge capture analysis and price change support. You will help maintain the charge master for compliance, accuracy, and consistency across NM.

The role involves leading audits, liaising with Revenue Cycle, IT, and clinical departments to connect EPIC with the charge master, and mentoring team members to improve processes and data modeling.

Qualifications

• Bachelor’s degree in Business or related field or 10 years of equivalent experience with progressive advancement.
• 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.
• Lead efforts to assess, modify, and/or develop and implement more timely and consistent processes/systems to increase efficiency, accuracy, and meaningfulness of information.

Skills

Microsoft Office

Revenue cycle experience

CPT/HCPCS/ ICD-10 knowledge

Medicare/Medicaid regulations

Communication & collaboration

Critical thinking

Education

Bachelor’s Degree in Business or related field

10 years equivalent experience

Tools

EPIC Certification (Resolute Charge Capture)

EPIC Certification (Clarity Report Data)

SQL (basic)

Relational databases

Job description

Northwestern Medicine in Illinois is seeking a Senior Revenue Integrity Analyst to support the Clinical Department and revenue cycle with charge capture analysis and price change support. You will help maintain the charge master for compliance, accuracy, and consistency across NM.

The role involves leading audits, liaising with Revenue Cycle, IT, and clinical departments to connect EPIC with the charge master, and mentoring team members to improve processes and data modeling.