Revenue Integrity Analyst

🔥 0 minutes ago

🐻 Alaska – Remote

🐻 Alaska – Remote

💵 $31 - $44 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

👻 Ghost score 0%

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SouthEast Alaska Regional Health Consortium (SEARHC)

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1975

⚕️ Healthcare Insurance

🏥 Healthcare

🧘 Wellness

Healthcare Insurance • Healthcare • Wellness

SouthEast Alaska Regional Health Consortium (SEARHC) is a dedicated healthcare organization serving the communities of Southeast Alaska. With a commitment to providing comprehensive medical care, SEARHC offers a wide range of services including primary care, specialty care, behavioral health, and various support programs across multiple locations. Their mission emphasizes community wellness and access to quality health services, ensuring that the unique health needs of the region's population are met.

📋 Description

• Optimize and troubleshoot revenue cycle applications • Collaborate with clinical, operational, supporting departments, and applicable stakeholders to develop integrated design solutions • Analyze available data to support Revenue Cycle team initiatives, including identification, definition, resolution planning, and implementation for system and user deviations, inconsistencies, and process failures • Serve as an internal resource on registration, authorizations, coding, CDI, CDM management, claims, edits, billing compliance, denials, remittance processing, and/or reporting and analytics • Perform workflow analysis • Analyze payer contracts and ensure payments are consistent with negotiated contracts • Identify root causes of controllable denials and partner with finance leadership to address operational issues, workflow issues, and training gaps • Perform quality assurance and validation tasks • Provide education and guidance to patient revenue-generating departments and providers to ensure appropriate charge capture

🎯 Requirements

• Bachelor's degree or an equivalent combination of education and/or work experience — Required • 4 years of work experience may be exchanged for a bachelor's degree • 2 years of experience in Revenue Cycle, Finance, or Clinical capacity • Knowledge of end user workflows including scheduling, registration, clinical, ancillary, coding, billing and claims processing, cash posting, and/or reporting • Knowledge of national and international code sets including ICD 10CM, DSM, CPT, HCPCS, Revenue Codes, CARC/RARC, and NCCI • Knowledge of payer edits, rejections, rules, and appropriate actions and requirements for resolution • Knowledge of billing, accounts receivable, collection practices, and/or reporting requirements for IHS, CAH, FQHC, Provider Based, LTC, Rehab, Behavioral Health (CBH, SUD, 1115), and/or Retail Pharmacy enrollments • Knowledge of file structure, configuration, requirements, and troubleshooting of UB 04, CMS 1500, 837I/P, 835, and/or NCPDP D.0 • Skills in critical thinking, problem solving, and troubleshooting • Creative solution design and execution for complex problems • Exposure to Microsoft Office programs, including Word and Excel • Experience with electronic health record applications • Ability to work on different projects simultaneously and multitask in a fast-paced environment • Ability to appropriately handle overlapping commitments and deadlines • Systematic, self-motivated approach to problem solving • Ability to work independently and collaboratively as needed • AAHAM, AAPC, AHIMA, PTCB, or other professional certification or licensure — Preferred

🏖️ Benefits

• Retirement • Paid time off • Paid parental leave • Health insurance • Dental benefits • Vision benefits • Life insurance • Long-term disability • Short-term disability • Professional advancement and development opportunities • Positive work culture • Sign-on bonuses for Registered Nurses, Hot Jobs and Certified Nurses Assistants