Charge Integrity Analyst 1

Charge Integrity Analyst I

Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our core values are : We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience.

Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include : Immediate eligibility for health and welfare benefits, 401(k) savings plan with dollar-for-dollar match up to 5%, Tuition Reimbursement, PTO accrual beginning Day 1. Note : Benefits may vary based upon position type and / or level.

Job Summary

The Charge Integrity Analyst I performs duties of moderate complexity, judgment, and scope. The associate must know professional and technical charge editing processes.

Essential Functions of the Role

Serves as an internal resource to clinical departments, revenue cycle operations, and other departments as needed to resolve charge errors. Accountable for claim edit and Discharged Not Billed (DNB) work queues in the patient accounting system. Accountable for professional charge review, claim edits, and follow-up edits in the patient accounting system. Maintains current knowledge of all professional and technical charge entry systems in the clinical and hospital billing systems. Maintains a basic to moderate knowledge of ordering processes, and how various systems flow for generation of charges for billing. Processes compliance audit corrections in the professional and / or technical charge review environment. Will report all potential compliance findings to management. Assists in the resolution of billing edits and denials. Acts as a liaison between management, billing, HIM, and clinical departments. Resolves errors related to professional or technical charge practices. Researches clinical documentation in the medical record to validate that charging activity is appropriate. Completes thorough and accurate documentation.

Key Success Factors

Working knowledge of hospital systems utilized in revenue cycle functions including registration, charge entry, order entry, and billing. Working knowledge of medical terminology. Ability to establish and maintain working relationships. Ability to communicate effectively and professionally with physicians, both in writing and orally; courtesy; initiative; resourcefulness. Excellent customer service skills. Proficient with MS Office applications. Must be willing to work varying hours according to work requirements, including nights and weekends. Proficient typing (35 wpm minimum) / keyboarding skills. Ability to multi-task. Must have revenue cycle experience in a healthcare setting. Experience with Epic is required. Collections experience. Front-end and back end revenue cycle knowledge is essential. Access service experience is preferred.

We believe that all people should feel welcomed, valued and supported.

Qualifications :

Education - H.S. Diploma / GED Equivalent Experience - Less than 1 Year of Experience