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Revenue Integrity Analyst

Medix Robbinsdale Full-Time
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Revenue Integrity Analyst

The goal of this position is to modernize their EPIC and revenue integrity process with a revenue integrity analyst at a senior level who will drive:

  1. Departmental Accountability

  2. Transparency

  3. Lower cost to collect

This candidate will need to be an EPIC super user, or close to that. They will need to be familiar with the revenue cycle practice of each department and how it flows through the hospital. Part of the work with EPIC is identifying how chargers are triggered, validating fee's, pricing, and charge capturing. More EPIC- build out "service now" - task assigned.This person needs to come from a hospital background someone coming from a payer background most likely will not have EPIC.

The background this person may come from is coding, business analyst (healthcare oriented), EPIC builder, one candidate they hired came from PB (payer billing) physician educator

The action they would like to accomplish is implementing a charge capture process "monitoring".

This includes:

  • Revenue Reconciliation

  • Revenue integrity committee/change control

  • Change method

  • Navigation (charge review work que)

The four main components of this position include the following (candidates do not need to have all 4 they need to have EPIC if they have all 4 they would get highest pay and be considered senior leveled)

  1. EPIC

  2. Charge Master (foundation- tool to push codes through in EPIC)

  3. Charging/Structure

  4. Revenue integrity committee (overall theme of charge capture and change control)

  5. Charge methodology

charge master, or charge description master (CDM), is a comprehensive listing of items billable to a URL blocked - click to apply URL blocked - click to apply or a patient's URL blocked - click to apply provider. In practice, it usually contains highly inflated URL blocked - click to apply at several times that of actual URL blocked - click to apply to the hospital.

Day to Day:

  • Educates operational departments on charge capture processes, fostering department responsibility to understand and be accountable for capturing charges.
  • Trains stakeholders in regulatory and payor updates impacting the charge capture process.
  • Ensures the sustainability and integrity of charge capture initiatives through consistent communication of results and development of training materials, as necessary.
  • Researches Medicare, CPT/HCPCS coding, and payor requirements for maximizing reimbursement and maintaining compliant practices related to charge capture.
  • Coordinates with EPIC team, IT, CDM, CDI, Coding, Business Office, Finance, operational departments, and other support staff in identifying workflow best practices to maximize the charge capture process.
  • Engages with departments/stakeholders to implement process improvement initiatives related to revenue enhancement opportunities.
  • Assesses site or department specific procedures to ensure revenue integrity and compliance with charge capture processes.
  • Assists and coordinates analysis of charts and performs focus reviews to support charge capture performance improvement.
  • Summarizes review findings and preliminary recommendations.
  • Assists departments in developing and maintaining charge capture reconciliation processes.
  • Analyzes charges to identify trends of missing or misdirect charges to resolve charge capture related issues.
  • Collaborates with Business Office and departments related to late charge entry process improvements to ensure accurate and efficient charging.
  • Collaborates with Business Office and departments to analyze denials and claims on hold due to charge errors; provides education to mitigate errors.
  • Facilitates the resolution of charge errors to assure appropriate and compliant revenue.
  • Responsible for understanding the accuracy and efficiency of technology systems and workflows for charging activities.
  • Reviews charging activities of each department to ensure that all activities are accounted for in the charge master and priced appropriately.

Revenue Integrity Analyst Senior The goal of this position is to modernize their EPIC and revenue integrity process with a revenue integrity analyst at a senior level who will drive: Departmental Accountability Transparency Lower cost to collect This candidate will need to be an EPIC super user, or close to that. They will need to be familiar with the revenue cycle practice of each department and how it flows through the hospital. Part of the work with EPIC is identifying how chargers are triggered, validating fee's, pricing, and charge capturing. More EPIC- build out "service now" - task assigned.This person needs to come from a hospital background someone coming from a payer background most likely will not have EPIC. The background this person may come from is coding, business analyst (healthcare oriented), EPIC builder, one candidate they hired came from PB (payer billing) physician educator The action they would like to accomplish is implementing a charge capture process "monitoring". This includes: Revenue Reconciliation Revenue integrity committee/change control Change method Navigation (charge review work que) The four main components of this position include the following (candidates do not need to have all 4 they need to have EPIC if they have all 4 they would get highest pay and be considered senior leveled) EPIC Charge Master (foundation- tool to push codes through in EPIC) Charging/Structure Revenue integrity committee (overall theme of charge capture and change control) Charge methodology charge master, or charge description master (CDM), is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider. In practice, it usually contains highly inflated prices at several times that of actual costs to the hospital. Day to Day: Educates operational departments on charge capture processes, fostering department responsibility to understand and be accountable for capturing charges. Trains stakeholders in regulatory and payor updates impacting the charge capture process. Ensures the sustainability and integrity of charge capture initiatives through consistent communication of results and development of training materials, as necessary. Researches Medicare, CPT/HCPCS coding, and payor requirements for maximizing reimbursement and maintaining compliant practices related to charge capture. Coordinates with EPIC team, IT, CDM, CDI, Coding, Business Office, Finance, operational departments, and other support staff in identifying workflow best practices to maximize the charge capture process. Engages with departments/stakeholders to implement process improvement initiatives related to revenue enhancement opportunities. Assesses site or department specific procedures to ensure revenue integrity and compliance with charge capture processes. Assists and coordinates analysis of charts and performs focus reviews to support charge capture performance improvement. Summarizes review findings and preliminary recommendations. Assists departments in developing and maintaining charge capture reconciliation processes. Analyzes charges to identify trends of missing or misdirect charges to resolve charge capture related issues. Collaborates with Business Office and departments related to late charge entry process improvements to ensure accurate and efficient charging. Collaborates with Business Office and departments to analyze denials and claims on hold due to charge errors; provides education to mitigate errors. Facilitates the resolution of charge errors to assure appropriate and compliant revenue. Responsible for understanding the accuracy and efficiency of technology systems and workflows for charging activities. Reviews charging activities of each department to ensure that all activities are accounted for in the charge master and priced appropriately.

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Job ID: 84500

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