Revenue Integrity Analyst

Job not on LinkedIn

🔥 4 minutes ago

🏈 Alabama, Alaska, +43 more states – Remote

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💵 $28 - $44 / hour

⏰ Full Time

🟢 Junior

🧐 Analyst

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

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Logo of Highmark Health

Highmark Health

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 • Collaborate continuously with facility and department leadership • Analyze root causes, monitor and audit revenue cycle activities, report findings, and provide education • 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; present 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 • Coordinate revenue cycle regulatory research and RAC and payer audit appeals • Serve as Revenue Cycle regulatory liaison and internal audit consultant • Identify barriers and implement corrective actions with organizational leaders • Provide ongoing guidance, training, and support to practices and Revenue Cycle staff • Monitor and audit Revenue Cycle policy and procedure compliance, including medical necessity issues • Identify undercharges and overcharges for provider or practice resolution • 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 a Epic-billing environment • Compliance with HIPAA, data security guidelines, the Code of Business Conduct, applicable federal and state laws, rules, regulations, company policies, and training requirements

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