Revenue Integrity Analyst – Epic Revenue Cycle Analyst, Hospital Experience Required, Epic Preferred
Lourdes Health System
full-time
Posted on:
Location Type: Hybrid
Location: Crawford Place • New Jersey • United States
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Salary
💰 $70,935 - $110,268 per year
About the role
- Perform quantitative and financial analysis along with audits designed to identify opportunities for improvement across the full spectrum of the Revenue Cycle.
- Assists in ensuring that the charge master and fee schedules are in accordance with government compliance policies and procedures, as well as third party payor needs.
- Review, identify, and analyze necessary CPT changes related to quarterly and annual AMA CPT updates and regulatory changes by timelines set.
- Works with revenue producing departments to ensure the ongoing coordinated consistency of the charge master and fee schedules, including accurate descriptions, coding, additions, deletions, pricing, and any other changes.
- Conduct analytical reviews determine net revenue effect of proposed charge master and fee schedule changes.
- Perform internal billing audits to ensure correcting coding/billing regulatory compliance and charge capture accuracy.
- Incumbent must develop close working relationships with management and staff in Revenue Integrity, Finance, Information Technology and Revenue and Clinical Operations allowing them to perform deep-dive analysis and reviews assisting with the identification of trends, solutions and potential corrective action steps.
- Will work both independently and have a high level of self-directed work efforts as well as be an integral part of the Revenue Integrity Team.
- Revenue Cycle will include areas from Hospital, Physician and Home Health.
- Monitor and assists with review of revenue cycle workqueues in Epic.
- Perform analysis to identify issues, trending, root cause, and action plan development with workqueue issues.
- Assist in strategic pricing process to optimize reimbursement within budget guidelines.
- Participate in ongoing coordination and resolution of revenue issues as they arise.
- Assists in troubleshooting and resolving issues related to the patient revenue cycle, and assists in development and recommendations.
- Provide guidance and communication and collaborate with Revenue Integrity Team, Clinical Operations and IT to help ensure workqueue rules are accurate and updated based on annual and quarterly coding changes.
- Assist with Epic performance reporting, including assisting with Revenue & Usage, Enterprise Charge Reconciliation and Volume Reports.
- Workqueue and reporting will include areas from Hospital, Physician and Home Health.
- Serve as resource to Patient Financial Services staff for reporting problems and denials on individual claims.
- Assist in researching coding issues, provide guidance and recommend solution to account representative.
- Analyze billing errors and denial data to identify root cause of issues.
- Work with Revenue Integrity Team, Clinical Operations and Patient Financial Services staff to implement corrective actions to ensure compliant charges, prevent future rejections/denials and accurate and reimbursement.
- Claim issues and denials will include areas from Hospital, Physician and Home Health.
- Lead and participate in projects related to Revenue Cycle initiatives.
- Participate in ongoing coordination and resolution of revenue issues as they arise.
- Provide input to Director and Manager for annual Revenue Integrity planning process.
- Assist with additional projects as needed for Hospital, Physician and Home Health.
Requirements
- 3 to 5 years experience within a large hospital or integrated healthcare delivery system
- Ability to work collaboratively across disciplines and business lines
- Exceptional oral/written communication skills and highly customer-focused
- Excellent interpersonal and presentation skills
- Ability to prioritize, plan and execute
- Excellent critical thinking, analytical skills
- Bachelor Degree, in Accounting, Finance, Healthcare preferred
- EPIC Revenue Integrity, Hospital Billing, Physician Billing Certification, preferred
Benefits
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Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
quantitative analysisfinancial analysisauditsCPT codingbilling auditscharge master managementrevenue cycle analysisroot cause analysisstrategic pricingreimbursement optimization
Soft Skills
collaborationcommunicationinterpersonal skillspresentation skillscritical thinkinganalytical skillsprioritizationplanningexecutioncustomer focus
Certifications
EPIC Revenue Integrity CertificationHospital Billing CertificationPhysician Billing Certification