Revenue Integrity Analyst

Job not on LinkedIn

🕒 August 28

🏈 Alabama, Alaska, +45 more states – Remote

🏈 Alabama – Remote 🐻 Alaska – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🏛️ District of Columbia – Remote 🐊 Florida – Remote 🌺 Hawaii – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $28 - $44 / hour

⏰ Full Time

🟢 Junior

🧐 Analyst

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 21%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Highmark Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1852

🛡️ Insurance

💼 Consulting

📦 Logistics

💰 $5M Grant on 2021-05

Insurance • Consulting • Logistics

Highmark Health is a healthcare company committed to reinventing the healthcare system and improving its services for everyone. The organization offers a broad range of career opportunities across various fields such as clinical care, technology, finance, and marketing. Highmark Health emphasizes diversity, equity, and inclusion in its workforce, creating a supportive environment for employees from all backgrounds. The company has been recognized for its commitment to disability inclusion, diversity, and military-friendly employment. As an independent licensee of the Blue Cross Blue Shield Association, Highmark Health strives to create remarkable healthcare experiences for its customers and employees alike.

📋 Description

• Perform reporting and analysis of the revenue cycle for monitoring and problem resolution • Assist staff with internal and external system issues, audits, and accounts receivable questions • Act as a primary liaison with other parties to resolve system issues and ensure regulatory compliance • Participate in department and system initiatives, including testing and related activities • Collaborate continuously with facility and department leadership • Analyze revenue cycle issues, including root cause analysis; monitor and audit; report and educate leadership • Establish and implement internal controls for complete and accurate documentation and billing • Optimize clinical documentation through analysis and prioritized evaluation • Maintain the integrity of the charge description master (CDM) and software program • Lead financial, statistical, and operational projects and present detailed A/R performance analyses and financial reports • Research and validate clinical data supporting medical necessity of billed services • Conduct quality assurance reviews of billing components, technical requirements, processes, systems, and documentation • Conduct consultative research and coordinate responses to revenue cycle regulatory risks, including medical necessity denials • Coordinate and manage RAC and payer audit appeals • Serve as Revenue Cycle regulatory liaison and internal audit consultant to clinical providers • Identify barriers and implement corrective actions with leaders • Provide guidance, training, and support to practices and Revenue Cycle staff • Monitor and audit Revenue Cycle performance and compliance through sample audits and assessments • Provide education on practice management systems, coding, billing, A/R workflows, policies, and regulatory requirements • Develop and implement action and educational plans • Assist with practice management system training and implementation for newly acquired hospitals, ASCs, and practices • Collaborate with Compliance, Budget Office, Patient Accounts, Health Information Services, Internal Audit, Revenue, and Finance departments • Develop and maintain a Quality Audit program and associated reporting • Perform other duties as assigned

🎯 Requirements

• High School/GED • 1-3 years in hospital or physician revenue cycle, billing, coding or billing • Preferred: Bachelor's Degree in Business, Healthcare or related field • Preferred: 1 year in Project Management • Preferred: 1 year in an Epic-billing environment • Compliance with HIPAA, privacy policies, information security policies, Code of Business Conduct, and applicable laws, rules, and regulations