Senior Analyst, Revenue Integrity, Procedural Supply Governance

🕒 4 days ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $42 - $61 / hour

⏰ Full Time

🟠 Senior

🎲 Risk

👻 Ghost score 0%

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Northwestern Medicine

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 $25M Grant on 2018-06

Healthcare • Healthcare Insurance • Pharmaceuticals

Northwestern Medicine is a renowned healthcare provider offering a wide range of medical services, including COVID-19 and flu vaccinations, cutting-edge treatments, and pioneering surgical procedures. The organization is deeply involved in clinical research, contributing to significant medical advancements such as exploring the causes of diseases like lupus and breakthroughs in cancer treatment. With a robust network of hospitals and specialized care centers, Northwestern Medicine is dedicated to patient wellness, community impact, and medical education. They emphasize accessibility, patient safety, and convenience through services like telehealth, financial assistance, and multilingual support. Whether it's immediate care, advanced procedures, or multidisciplinary care for complex conditions, Northwestern Medicine is committed to leading the way in healthcare innovation and patient-centered care.

📋 Description

• Support the Clinical Department and revenue cycle • Perform charge capture analysis, including annual price increase analysis • Maintain the charge master for compliance, accuracy, and consistency • Prepare analyses and support for management and Clinical Departments • Perform daily EAP maintenance and quarterly audits • Prepare files for required EAP database department builds • Identify charge capture opportunities in revenue-producing departments • Research and interpret billing and coding regulations and communicate changes to impacted areas • Lead quarterly audits of charge master data elements • Review departmental front-end charge capture tools for accuracy • Lead complex audits and prepare methodologies for annual pricing and coding changes • Troubleshoot complex account errors and educate Revenue Managers on resolution • Resolve questions concerning charge capture and complex regulatory billing issues, including Provider-Based status rules, OPPS, CCI, and MUE • Liaise with Revenue Cycle, IT, and clinical departments to link EPIC and the charge master • Research, compile, and analyze financial data and maintain database files for financial modeling • Mentor and support Revenue Integrity Team members as an informal leader • Assess, modify, develop, and implement processes and systems to improve efficiency, accuracy, and meaningfulness of information • Maintain professional and technical knowledge through workshops, publications, networks, best practices, and professional societies • Support finance, operations, and revenue cycle teams through special projects • Protect confidential financial and patient information • Support Northwestern Medicine’s finance operations

🎯 Requirements

• Bachelor’s Degree in Business or related field, or 10 years of equivalent experience with progressive advancement • Proficiency with Microsoft Office Suite • 5+ years in a revenue cycle or revenue integrity role • Advanced understanding of CPT, HCPCS, ICD-10, and third-party billing requirements • Extensive knowledge and experience with Medicare/Medicaid regulations • Strong communication, collaboration, and analytical skills • Critical thinking, decisive judgment, high attention to detail, and ability to work with minimal supervision • EPIC Certification (Resolute Charge Capture) preferred • EPIC Certification (Clarity Report Data) preferred • Master’s degree in Healthcare Management, Business, MIS, Data Analytics, or related field preferred • Beginner to moderate knowledge of SQL and relational databases preferred • RHIA or related healthcare credential preferred • Must complete a criminal-history background check if offered the position • Must comply with applicable policies, regulations, accreditation standards, and Illinois healthcare worker background-check requirements

🏖️ Benefits

• Competitive benefits • Tuition reimbursement • Loan forgiveness • 401(k) matching • Lifecycle benefits • Employee physical, emotional, and financial well-being resources • Protection for unexpected life events

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