Revenue Integrity Analyst
EMPLOYER PAID PENSION PLAN OF 29.25% OF YOUR ANNUAL SALARY!
GENEROUS BENEFITS PACKAGE!
THIS POSITION MAY CLOSE WITHOUT NOTICE ONCE A SUFFICIENT NUMBER OF QUALIFIED APPLICATIONS ARE RECEIVED.
Maintains the Chargemaster fee schedule in accordance with established coding practices and governmental regulatory requirements. Conducts quality control audits and review charge capture clinical workflows for missed revenue opportunities. Creates action plans for capturing missed revenue. Identifies edits in patient management/billing software that impacts billing accuracy. Ensures CPT, HCPCS and revenue codes are accurate and compliant will all charging and billing guidelines. Serves as a liaison between Revenue Cycle and clinical operations and information technology regarding revenue, compliance, and clinical workflow build.
Graduation from an accredited school of nursing or equivalent to a Bachelor's Degree in healthcare, finance or a closely related field and three (3) years experience in reviewing hospital charge capture, medical records, clinical charts, regulatory and policy compliance, and/or claims auditing.
Current License by the Nevada State Board of Nursing to Practice as a Registered Nurse, or certification in one of the following: American Health Information Management Association (AHIMA) credentials: Registered Health Information Management Administrator or Technician (RHIA/RHIT), Certified Coding Specialist (CCS).
Additional and/or Preferred Position Requirements
- Recent experience (within the last 5 years) with Epic andCraneware
- Experience as a Revenue Integrity Analyst in a hospital setting. Ability to teach and train clinicians on "proper" charging methodologies.
- Knowledge of CPT,HCPCSand revenue codes
Knowledge, Skills, Abilities, and Physical Requirements
Compliance regulations related to charge capture, clinical documentation, coding, and billing requirements; Epic and Craneware systems; clinical revenue integrity processes and impact through revenue cycle; charge master, coding principles and guidelines including, but not limited to CPT, E&M, HCPCS, code edits, auditing, denials management, documentation improvement and related revenue cycle workflows; auditing concepts and principles; reviewing medical records and coding documents according to standard practice; department and hospital safety practice and procedures; patient rights; age specific patient care practices; infection control policies and practices; handling, storage, use and disposal of hazardous materials; department and hospital emergency response policies and procedures.
Developing effective solutions for complex business challenges; leading teams to consensus; developing training materials; reviewing and verifying accuracy of data; reviewing medical records and coding documents according to standard practice; using initiative and independent judgment within general policy guidelines; preparing clear and concise reports,correspondence and other written materials; using computers and related software applications; communicating with a wide variety of people from diverse socio-economic and ethnic backgrounds; establishing and maintaining effective working relationships with all personnel contacted in the course of duties; efficient, effective and safe use of equipment.
Physical Requirements and Working Conditions:
Mobility to work in a typical office setting and use standard equipment, stamina to remain seated for extended periods of time, vision to read printed materials and a VDT screen, and hearing and speech to communicate effectively in person and over the telephone. Strength and agility to exert up to 20 pounds of force occasionally and/or an eligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification.
Closing Date/Time: Continuous