Revenue Integrity Analyst (Full-Time) Hybrid

Virtua Health Revenue Cycle Analyst

At Virtua Health, we exist for one reason to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in between we are your partner in health devoted to building a healthier community. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment. In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics.

Location : Mount Laurel, NJ

Employment Type : Employee

Employment Classification : Regular

Time Type : Full time

Work Shift : 1st Shift (United States of America)

Total Weekly Hours : 40

The following experience is strongly preferred :

EPIC

Hospital charge description master experience

Charge audits

Coding & billing guidelines

Job Summary :

The position is responsible for root cause analytics along with audits to help identify opportunities, issues, and process improvement within the Revenue Cycle. This role supports the revenue cycle workflows, charge capture, workqueue and denial review processes within an Epic based EMR.

Position Responsibilities :

Perform quantitative and financial analysis along with audits designed to identify opportunities for improvement across the full spectrum of the Revenue Cycle.

Assists in ensuring that the charge master and fee schedules are in accordance with government compliance policies and procedures, as well as third party payor needs. Review, identify, and analyze necessary CPT changes related to quarterly and annual AMA CPT updates and regulatory changes by timelines set. Works with revenue producing departments to ensure the ongoing coordinated consistency of the charge master and fee schedules, including accurate descriptions, coding, additions, deletions, pricing, and any other changes. Conduct analytical reviews determine net revenue effect of proposed charge master and fee schedule changes. Perform internal billing audits to ensure correcting coding / billing regulatory compliance and charge capture accuracy.

Incumbent must develop close working relationships with management and staff in Revenue Integrity, Finance, Information Technology and Revenue and Clinical Operations allowing them to perform deep-dive analysis and reviews assisting with the identification of trends, solutions and potential corrective action steps. Will work both independently and have a high level of self-directed work efforts as well as be an integral part of the Revenue Integrity Team. Revenue Cycle will include areas from Hospital, Physician and Home Health.

Monitor and assists with review of revenue cycle workqueues in Epic. Perform analysis to identify issues, trending, root cause, and action plan development with workqueue issues.

Assist in strategic pricing process to optimize reimbursement within budget guidelines. Participate in ongoing coordination and resolution of revenue issues as they arise. Assists in troubleshooting and resolving issues related to the patient revenue cycle, and assists in development and recommendations.

Provide guidance and communication and collaborate with Revenue Integrity Team, Clinical Operations and IT to help ensure workqueue rules are accurate and updated based on annual and quarterly coding changes.

Assist with Epic performance reporting, including assisting with Revenue & Usage, Enterprise Charge Reconciliation and Volume Reports. Workqueue and reporting will include areas from Hospital, Physician and Home Health.

Serve as resource to Patient Financial Services staff for reporting problems and denials on individual claims. Assist in researching coding issues, provide guidance and recommend solution to account representative.

Analyze billing errors and denial data to identify root cause of issues. Work with Revenue Integrity Team, Clinical Operations and Patient Financial Services staff to implement corrective actions to ensure compliant charges, prevent future rejections / denials and accurate and reimbursement. Claim issues and denials will include areas from Hospital, Physician and Home Health.

Lead and participate in projects related to Revenue Cycle initiatives. Participate in ongoing coordination and resolution of revenue issues as they arise. Provide input to Director and Manager for annual Revenue Integrity planning process. Assist with additional projects as needed for Hospital, Physician and Home Health.

Position Qualifications Required :

Required Experience : 3 to 5 years experience within a large hospital or integrated healthcare delivery system.

• Ability to work collaboratively across disciplines and business lines.
• Exceptional oral / written communication skills and highly customer-focused.
• Excellent interpersonal and presentation skills.
• Able to communicate with many, various customers.
• Ability to prioritize, plan and execute.
• Excellent critical thinking, analytical skills.

Required Education : Bachelor Degree, in Accounting, Finance, Healthcare preferred

Training / Certification / Licensure : EPIC Revenue Integrity, Hospital Billing, Physician Billing Certification, preferred

Annual Salary : $68,878 - $109,958 The actual salary / rate will vary based on applicant's experience as well as internal equity and alignment with market data. Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to : medical / prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies.

For more benefits information click here.