Revenue Integrity Analyst

This is a fully remote position, open to applicants in Alaska.

📋 Description

• Optimize and troubleshoot applications related to the revenue cycle.

• Collaborate with clinical, operational, and support departments, along with relevant stakeholders to devise integrated design solutions.

• Analyze existing data to assist the Revenue Cycle team’s initiatives, which include identifying, defining, planning resolutions, and implementing solutions for system and user discrepancies, inconsistencies, and process failures.

• Act as an internal resource on registration, authorizations, coding, Clinical Documentation Improvement (CDI), Charge Description Master (CDM) management, claims, edits, billing compliance, denials, remittance processing, and/or reporting and analytics.

• Conduct workflow analysis.

• Evaluate payer contracts to ensure payments align with negotiated agreements.

• Identify root causes of controllable denials and collaborate with finance leadership to address operational challenges, workflow issues, and training deficiencies.

• Execute quality assurance and validation tasks.

• Provide education and guidance to patient revenue-generating departments and providers to ensure accurate charge capture.

⛳️ Requirements

• Bachelor's degree or an equivalent combination of education and/or work experience — Required.

• Four years of work experience may substitute for a bachelor's degree.

• Two years of experience in Revenue Cycle, Finance, or Clinical roles.

• Familiarity with end-user workflows, including scheduling, registration, clinical, ancillary, coding, billing and claims processing, cash posting, and/or reporting.

• Knowledge of national and international coding systems such as ICD 10CM, DSM, CPT, HCPCS, Revenue Codes, CARC/RARC, and NCCI.

• Understanding of payer edits, rejections, rules, and the appropriate actions and requirements for resolution.

• Knowledge of billing, accounts receivable, collection practices, and/or reporting requirements for IHS, CAH, FQHC, Provider Based, LTC, Rehab, Behavioral Health (CBH, SUD, 1115), and/or Retail Pharmacy enrollments.

• Understanding of file structures, configurations, requirements, and troubleshooting related to UB 04, CMS 1500, 837I/P, 835, and/or NCPDP D.0.

• Proficient in critical thinking, problem-solving, and troubleshooting skills.

• Ability to create and implement innovative solutions for complex issues.

• Experience with Microsoft Office applications, including Word and Excel.

• Familiarity with electronic health record systems.

• Capable of managing multiple projects simultaneously and multitasking in a fast-paced environment.

• Ability to effectively manage overlapping commitments and deadlines.

• Systematic and self-motivated approach to problem-solving.

• Competent in working both independently and collaboratively as needed.

• AAHAM, AAPC, AHIMA, PTCB, or other professional certification or licensure — Preferred.

🏝️ Benefits

• Retirement plans.

• Paid time off.

• Paid parental leave.

• Health insurance coverage.

• Dental benefits.

• Vision benefits.

• Life insurance.

• Long-term disability coverage.

• Short-term disability coverage.

• Opportunities for professional advancement and development.

• Positive work culture.

• Sign-on bonuses for Registered Nurses, Hot Jobs, and Certified Nurses Assistants.