Sr Revenue Integrity Analyst Full Time 40 hours

Bristol Hospital and Health Care Group, Inc.; Bristol (CT); On-site; USD 50,000 - 80,000; Full time

Job summary

An established healthcare provider is seeking a Sr Revenue Integrity Analyst to enhance revenue capture strategies. In this role, you'll leverage your expertise in billing practices and coding to ensure compliance and maximize financial performance. You'll collaborate with various departments to resolve discrepancies and provide analytical insights into revenue trends. This position offers a unique opportunity to make a significant impact in a community-focused organization committed to quality care. If you are passionate about improving healthcare operations and have a keen eye for detail, this role is perfect for you.

Benefits

Sign-on Bonus

Health Insurance

Retirement Plan

Paid Time Off

Professional Development Opportunities

Qualifications

• 2+ years of experience in revenue cycle processes and billing practices.
• Advanced knowledge of CPT, HCPCS, and ICD 10 coding.
• Understanding of reimbursement theories including DRG and OPPS.

Responsibilities

• Assist with maximizing revenue capture and CDM maintenance.
• Monitor changes to coding and billing rules for compliance.
• Provide analytics on charging trends and payment variances.

Skills

Statistical Analysis

Insurance Claim Processing

Regulatory Compliance

Communication Skills

Problem-Solving

Education

Associate or Bachelor's Degree in Finance

Tools

Excel

Word

MediTech

Job description

Job Details

Job Location: BHI Valley St - Bristol, CT

Position Type: Full Time

Education Level: High School

Salary Range: Undisclosed

Job Shift: 1st Shift (Days)

Description

Eligible for $5,000 sign on bonus

At Bristol Health, we begin each day caring today for your tomorrow. We have been an integral part of our community for the past 100 years. We are dedicated to providing the best possible care and service to our patients, residents and families. We are committed to provide compassionate, quality care at all times and to uphold our values of Communication, Accountability, Respect and Empathy (C.A.R.E.). We are Magnet and received the 2020 Press Ganey Leading Innovator award for our rapid adoption and implementation of healthcare solutions during the COVID-19 pandemic. Use your expertise, compassion, and kindness to transform the patient experience. Make a difference. Make Bristol Health your choice.

JOB SUMMARY:

Function: Under the direction of the Revenue Integrity Manager, the Sr Revenue Integrity Analyst assists with the strategy for maximizing gross and net revenue capture across the Bristol Health enterprise. Primary responsibilities will include Charge Description Master (CDM) maintenance, strategic pricing, payment validation, and payer contract maintenance.

ESSENTIAL JOB FUNCTIONS:

• Evaluate current charging/coding structures in revenue generating departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements
• Monitors changes to coding and billing rules and share findings with appropriate practices and departments. Responds to departmental charging inquiries in a timely manner
• Assess the accuracy of all charging vehicles, including clinical systems and dictionaries, encounter forms and other charge documents used to capture revenue
• Ensure the Charge Description Master is maintained and changes are made in a timely manner
• Provide analytics on charging trends and accuracy, strategic pricing and reconciliation requirements
• Oversee payer reimbursement variance trends
• Coordinate with Leadership, Contract Management and other Revenue Cycle team members to resolve charge discrepancies and payment variance issues
• Assist with revenue improvement opportunities and analysis of financial impact as related to professional and hospital clinical departments
• Other duties as assigned

KNOWLEDGE / SKILLS / ABILITIES:

• Ability to understand and interpret statistical reports and perform quantitative analysis.
• Excellent understanding of multiple clinical disciplines and charging practices
• Knowledge and understanding of insurance claim processing and third-party reimbursement
• Knowledge of state and federal regulations as they pertain to billing processes and procedures
• Knowledge of healthcare related financial and/or accounting practices
• Skill in effective oral, written, and interpersonal communication
• Experience in leading projects and independent work efforts
• Skill in problem-solving in a variety of settings and translation of data into actionable steps
• Ability to read, understand and interpret, analyze, and apply complex regulatory requirements
• Ability to work independently and take initiative

Qualifications

REQUIRED EDUCATION / EXPERIENCE:

• At least two years of experience revenue cycle processes and billing practices.
• Advanced knowledge of code data sets to include CPT, HCPCS, and ICD 10
• Understanding of reimbursement theories to include DRG, OPPS, HCC and managed care. Ability to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations
• Associate or bachelor’s degree in finance or related field. A combination of education and experience acceptable.

Educational / Minimum Requirements:

REQUIRED EDUCATION / EXPERIENCE:

• At least two years of experience revenue cycle processes and billing practices.
• Advanced knowledge of code data sets to include CPT, HCPCS, and ICD 10
• Understanding of reimbursement theories to include DRG, OPPS, HCC and managed care. Ability to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations
• Associate or bachelor’s degree in finance or related field. A combination of education and experience acceptable.

Bristol Hospital Mandated Educational Requirements:

General orientation at time of hire. Fire/Safety/Infection Control annually. Other programs as mandated by Hospital.

Special Requirements:

Intermediate knowledge of Excel and Word is required. MediTech or other hospital billing systems is beneficial.

Physical Requirements:

Extending sitting at desk and/or computer terminal. Extensive eye usage.

Work Environment:

Normal office conditions. This job is on site at 32 Valley Street Bristol Ct.

Cognitive Requirements:

Must be able to think independently, analyze information, execute written and oral instructions, follow directions, and have good mathematical aptitude.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.