Senior Revenue Integrity Analyst

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

📋 Description

• Reviews, assesses, and confirms the accuracy of the Charge Description Master (CDM), fee schedules, and related master files. Documents and communicates annual or interim price adjustments.

• Aids the Director of Revenue Integrity in enhancing charge capture and revenue reconciliation at the departmental level to ensure all charges are accurately recorded.

• Advocates for and implements standardized statistics and productivity metrics collected through charge master services, uniform billing codes for comparable services, consistent revenue billing criteria for managed care contracts, and strategic pricing and markup formulas for designated facilities or programs.

• Ensures regular updates to the CDM, aligns financial systems with the CDM maintenance vendor's tool on a monthly basis, ensures smooth operation of scripts, trains new users, and maintains ongoing communication with CDM maintenance vendor support regarding issues and suggestions for product enhancement.

• Offers assistance, investigation, research, interpretations, education, reference materials, documentation, and policies related to CDM and Compliance issues or inquiries for both internal and external partners.

• Collaborates with and educates clinical staff to enhance the charging process.

• Conducts periodic evaluations of each CDM to deactivate or eliminate obsolete, inactive, and non-billable charge codes.

⛳️ Requirements

• Minimum: Bachelor’s degree or equivalent work experience, or two years of work experience for every one year of required education.

• Minimum: Coding certification (CCS, CCS-P, CPC, COC).

• Preferred: Registered Nurse; RHIA, Epic Certification in Resolute Charge Capture and/or Clarity Report Data; Certified Revenue Integrity Professional (CRIP) from the American Association of Healthcare Administrative Management (AAHAM).

• Minimum: Proficiency in MS Excel; understanding of billing requirements related to charges and associated claim forms; familiarity with cost accounting concepts, principles, and computer applications.

• Preferred: Experience with electronic medical records and clinical application software.

• Demonstrates initiative in raising issues; capable of educating and supporting colleagues in the successful execution of payer and financial tasks.

• Communicates effectively, able to articulate clearly in verbal, electronic, and written forms.

• Capable of identifying procedural issues that require improvement and participating in change processes.

🏝️ Benefits

• Pay for non-physician roles is determined by years of relevant experience and internal equity. Eligible employees may receive additional compensation forms, including shift differentials, on-call pay, incentive pay, and bonus opportunities when applicable. Managerial positions and above may participate in Cottage Health’s annual management incentive program. Physician compensation is based on specialty and may include bonus potential. For further details on our comprehensive Total Rewards offerings, please visit https://cottagehealth.org/careers/total-rewards.