Revenue Integrity Analyst
- Norfolk, VA
- $53,248-88,754 per year
- Permanent
- Full-time
- With responsibility for all cost centers within service lines and acting with a high degree of autonomy, performs reviews and makes updates related to Charge Description Master (CDM) integrity.
- Evaluates current charging processes to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements, to ensure consistency across all entities.
- Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications.
- Assesses the accuracy of all charging vehicles, including Epic and ancillary clinical systems and dictionaries, encounter forms, and other charge documents.
- Provides guidance, communication, and education on correct charge capture, coding, and billing processes to multiple clinical departments and entities.
- Participates in complex projects related to revenue cycle initiatives.
- Collaborates with Revenue Operations, Compliance, Budget Offices, Patient Accounts, Health Information Services, Internal Audit, and other Revenue and Finance departments on revenue management initiatives, across all entities.
- Develops, maintains, and implements Revenue Integrity and CDM Management policies, procedures, and training materials.
- Work and analyze billing error and denial data to identify root causes. Executes work plans to correct identified deficiencies.
- Serves as subject matter expert (SME) of Epic charge capture methodologies and helps investigate and solve charging issues and provide charge capture recommendations to clinical departments and hospital staff.
- Prepare monthly and year-to-date statistical reports using analytical tools to exemplify findings and ensure accurate financial reporting.
- Participate in various special projects such as quarterly and annual CPT/HCPCS changes, annual pricing updates, and other related projects and duties as assigned.
- Three years of healthcare-related experience required
- Requires advanced proficiency in Microsoft Office Suite, especially in MS Excel. Experience with EPIC P/R and Craneware (Chargemaster Toolkit/Online Reference Toolkit) is a plus.
- Financial management skills, including the ability to financially analyze data for operations to provide guidance to department managers
- Knowledge of CPT/ HCPCS codes and Revenue Codes. Understanding of revenue integrity processes and their impact throughout the revenue cycle. Must demonstrate excellent communication skills including oral and written comprehension and expression.