Senior Revenue Integrity Analyst

📋 Description

• Drives initiatives to guarantee that precise, thorough, and complete charge (revenue) reconciliation is conducted by departments that generate charges.

• Actively assesses Epic charging logic, encompassing charge triggers, routing rules, and management of work queues.

• Executes advanced analytics to pinpoint financial discrepancies, operational deficiencies, and revenue risks.

• Collaborates with coding, clinical leadership, finance, and IT to create and implement enhancements in charge capture and billing procedures.

• Develops and oversees the creation of intricate reports, dashboards, and analyses.

• Offers training, mentorship, and support to Revenue Integrity Analysts and departmental personnel.

• Takes the lead or co-leads enterprise initiatives associated with charge workflows, revenue integrity, regulatory compliance, or service-line evaluations.

• Recognizes and escalates systemic compliance or reimbursement risks to management.

⛳️ Requirements

• At least 5 years of experience in Billing, Charge Capture, Charge Description Master (CDM) Management, Revenue Cycle Analytics, or Revenue Integrity within the healthcare sector.

• Comprehensive understanding of charge capture processes, charge router logic, charging methodologies, and clinical workflows.

• In-depth knowledge of healthcare coding systems, including Current Procedural Terminology (CPT), Healthcare Common Procedure Coding Systems (HCPCS), and International Classification of Diseases (ICD-10), along with reimbursement methodologies.

• Strong grasp of Epic workflows, covering charge router, charge review, work queues, and Charge Description Master (CDM) integration.

• Proficient in data analysis, including large datasets, financial modeling, and root-cause analysis.

• Familiarity with healthcare regulatory requirements and revenue cycle operations.

• Exceptional leadership and collaboration abilities.

• Outstanding communication skills, both written and verbal, ensuring clear and concise information delivery.

• Strong organizational skills and meticulous attention to detail.

• Capability to educate and mentor staff, influence decision-makers, and convey technical concepts to non-technical audiences.

• Proficient in independently managing complex projects, timelines, and cross-functional deliverables.

🏝️ Benefits

• None.