Senior Revenue Integrity Analyst
Description
Master (CDM) and related audits with a focus on revenue cycle integrity.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 payor requirements.
Assesses the accuracy of all charging vehicles, including clinical systems and dictionaries, encounter forms and other charge documents. (20%)
Leads and participates in complex projects related to revenue cycle initiatives. Provides oversight for projects in which RI analysts are involved.
Develops, implements and maintains Revenue Integrity and CDM Management policies, procedures and training materials. (20%)
- Collaborates with Compliance, Budget Office, Patient Accounts, Health Information Services, Internal Audit and other Revenue and Finance departments on revenue management initiatives. (10%)
- Develops and maintains a Quality Audit program and associated reporting. Assists in performance of quality audits related to other team members' identified areas of opportunity. (10%)
- Other duties as assigned.
QUALIFICATIONS : Minimum
Minimum
- Bachelor's Degree in Business, Healthcare or related field OR six (6) of related experience in lieu of degree
- 5 years hospital or physician revenue cycle, billing, coding or billing
- Experience with electronic health records (EPIC)
Preferred
- 3 years in a Epic-billing environment
- 3 years with specific emphasis on regulatory issue and policy development, advanced knowledge of healthcare regulatory policies
Pay Range Minimum : $28.18
$28.18
Pay Range Maximum : $43.80
$43.80
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation / gender identity or any other category protected by applicable federal, state or local law.
Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation / gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities / Women / Protected Veterans / Disabled / Sexual Orientation / Gender Identity ()
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