Revenue Assurance Analyst II

🔥 4 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

🔴 Lead

🧐 Analyst

👻 Ghost score 10%

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The University of Kansas Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1998

🏥 Healthcare

⚕️ Healthcare Insurance

📚 Education

Healthcare • Healthcare Insurance • Education

The University of Kansas Health System is a comprehensive healthcare provider that partners with the University of Kansas Medical Center to offer top-tier medical services and education. It is recognized for its excellence in patient care, research, and education, with services ranging from urgent care to specialized cancer treatment at its NCI-designated cancer center. As a nonprofit organization, it relies on donations to provide high-quality healthcare to the community. Additionally, it offers a variety of educational opportunities through residency programs and fellowships, and emphasizes the importance of wellness and holistic health management for patients and professionals alike.

📋 Description

• Work with the Director and Assistant Director of Revenue Assurance, Audit, and Advisory Services to develop and perform reviews • Communicate recommendations and provide education to department leadership and providers based on audit findings • Perform federal and state regulatory research • Make presentations to internal and external audiences • Conduct regular comprehensive audits of internal controls, financial records, legal and regulatory compliance, and health system policies • Identify compliance issues, assess risks, and recommend solutions • Analyze and prepare reports on audit findings with recommendations to leadership and providers • Monitor new laws and regulations affecting health system operations and internal policies • Perform high-risk/high-dollar audits of clinical, operational, and financial processes for regulatory, payer-policy, and billing accuracy compliance • Facilitate external government and commercial payer audits, including tracking audits, responding to documentation requests, and appealing denials • Review and educate HIM coding and billing staff on peer review, coding, and billing rules • Prepare clear, concise audit workpapers • Mentor providers and clinical staff on billing and coding compliance • Follow up with auditees regarding management responses and implementation of recommendations • Address compliance queries from Medicare, Medicaid, third parties, internal legal counsel, the Hospital Executive office, and other interested parties • Serve as a billing guidance resource for HIM coding and billing staff • Conduct meetings with health system leadership and clinicians to review findings and recommendations • Use audit procedures and analytical tools for special projects • Research commercial contract requirements and reimbursement logic • Participate as a subject-matter expert in Revenue Cycle/HITS workgroups

🎯 Requirements

• Associate's Degree OR high school graduate with 7 or more years of experience in a healthcare compliance-related audit field • 5 or more years of medical chart auditing, claims and billing, coding, or applicable experience • Required certification or credential: Certified Professional Coder (CPC), Certified Public Accountant (CPA), Registered Health Information Administrator (RHIA), Registered Nurse, Certified Health Care Compliance certification, or other applicable certifications including Epic proficiency or certifications • Proficient knowledge of medical terminology, ICD-10, and CPT codes • Knowledge of Medicare, Medicaid, and other federal/state compliance guidelines • Excellent communication skills • Coding knowledge • Ability to perform professional, clinical, and/or technical competencies of the assigned unit or department

🏖️ Benefits

• Equal employment opportunity employer • Reasonable accommodations for qualified individuals with disabilities • Employment with the health system contingent upon agreeing to the health-system dispute-resolution program and signing the agreement to the DRP