Revenue Integrity Analyst II

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

📋 Description

• Execute billing processes, follow up, and resolve issues that hinder or delay payment for patient accounts.

• Ensure accurate charge capture, account assignments, claim adjustments, and charge modifications for designated service lines.

• Oversee and promote consistent charge capture and charge modifications to ensure compliance with regulations and optimize revenue.

• Assist in the development and management of integrated charge capture workflows in collaboration with senior analysts and leadership.

• Work in conjunction with clinical teams and clinical application groups.

• Analyze data, generate reports, assess trends, and propose enhancements.

• Conduct data mining, provide mentoring and training, review regulatory and payer policies, and abstract both financial and clinical data.

• Present findings, conduct research, and follow up on topics discussed at departmental and system-wide initiative levels.

• Monitor trends in coding, charge capture, and editing to enhance team performance.

• Conduct research and stay informed about CMS, federal and state regulations, and payer guidelines.

• Audit and assess system automation by comparing charge/claim data with clinical records.

• Utilize system capabilities to streamline compliant and optimized hospital claim processing.

• Offer education and guidance to revenue cycle teams, revenue practice teams, and clinical operations.

• Mentor and assist in training other revenue integrity analysts.

⛳️ Requirements

• Current certification from AAPC, AHIMA, HFMA, or another recognized medical coding organization.

• Experience in a detail-oriented position requiring strong organizational and analytical skills.

• Proven proficiency with Epic clinical and/or billing software applications.

• Capability to be flexible and adapt to changing situations.

• Ability to work effectively in a clinical operational area and/or as part of a revenue integrity team.

• Experience collaborating closely with a multidisciplinary team to enhance patient experience and operational success.

• Advanced understanding of regulations, payer policies, charge capture processes, and/or revenue monitoring.

• Bachelor’s degree in healthcare administration, medical, or a related analytical field from an accredited institution is preferred.

• Educational credentials will be verified.

• Proficient or certified in Epic clinical or billing applications is preferred.

🏝️ Benefits

• Comprehensive benefits package encompassing wellness, health, security, connection, and engagement programs.

• PEAK program offering upfront tuition coverage paid directly to the educational institution.

• Access to over 100 learning options, including undergraduate studies, high school diplomas, and professional skills and certificates.

• PEAK eligibility commencing on the first day of employment.