Sr Revenue Integrity Analyst Remote

This position services as the liaison with clinical service line leaders and staff, conducting revenue capture related audits and ensuring efficient, effective, and compliant charge capture.

What You Will Do

• Completes focused charge review assessments for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes.
• Assesses the accuracy of all charging vehicles, including clinical systems, encounter forms and other charge documents.
• Leads charge audits. Meets with departmental leadership to review findings, documentation standards and recommendations for improvement.
• Identifies charge trends and compiles information to determine focused reviews needed.
• Assists in leading annual maintenance and routine analysis of the Charge Description Master.
• Evaluates current charging and coding structures and processes in clinical departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements.
• Advises service line leaders and their staff on proper usage of charge codes; identifies opportunities for capturing additional revenue in accordance with payer guidelines; develops specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections.
• Works with service line leaders as new services, departments, supplies are introduced to ensure timely and accurate development of charges and charge capture methods.
• Provides guidance and communication on correct charge capture, coding and billing processes to clinical departments and facilities.
• Expected to identify, report, and participate in the resolution of any potential or actual revenue/charge related issues.
• Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars and publications, and shares as appropriate.
• Provides coding, documentation and compliance guidance as requested.
• Assists and directly provides training and orientation in group settings as well as one-on-one.
• Responds to departmental charging inquiries timely and seeks guidance when appropriate.
• Works with Coding and other clinical departments to identify/fix errors based on ICD/CPT Coding Guidelines and National Correct Coding Initiative edits.
• Contributes in the support of quarterly improvement initiatives as directed by department director or manager.
• Monitors applicable Revenue Integrity KPIs.
• Assist Revenue Cycle departments with special procedures and various duties as assigned.
• Success completion of proficiency required to gain access to applicable systems.

Additional Responsibilities

• Performs other duties as assigned.
• Complies with all policies and standards.
• For specific duties and responsibilities, refer to documentation provided by the department during orientation.
• Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.