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Technology-driven revenue cycle management services for healthcare providers.
Revenue Integrity Analyst II
Location
United States
Posted
139 days ago
Salary
$46.6K - $66.1K / year
Seniority
Senior
Job Description
Revenue Integrity Analyst II
R1 RCM
• Prepares Excel analysis, including V-Lookups and pivot tables. • Gathers and compiles data in a systematic fashion, clearly documenting assumptions, and validating accuracy of information to resolve inconsistencies. • Evaluate and implement charge requests with appropriate CPT/HCPCS codes, revenue codes, and pricing, ensuring alignment with clinical services and coding/billing guidelines. • Conducts Charge Capture Audits: Review and analyze patient records, billing data, and financial statements to ensure charge and coding compliance. • Identify discrepancies or errors and develop action plan for future state resolution. • Analyzes data to identify likely relationships, summarizes data and prepares summary materials for discussion with clinical and finance teams. • Monitor regulatory changes and payer updates that may impact charge master and revenue integrity. • Collaborates with various departments to resolve CDM or RI discrepancies (Utilization Management (UM), Clinical Documentation Integrity (CDI), RCM, Coding Services, Clinical Departments, and Health Information Management (HIM)). • Serve as a liaison during system upgrades, new service implementation, and pricing reviews.
Job Requirements
- Expertise in charge description master, CPT/HCPCS, NCCI, MUE, pricing, and payer contracts.
- Strong skills in V-Lookups and pivot tables.
- Systematic data gathering, compilation, and validation.
- Accurate documentation and data accuracy.
- Understanding of billing and revenue recognition.
- Conducting charge capture audits and identifying discrepancies.
- Analyzing data and summarizing findings.
- Running and extracting accurate reports.
- Working with various departments (UM, CDI, RCM, etc.).
- Strong verbal and written skills.
- Problem-Solving: Developing action plans for discrepancies.
- Stakeholder Management: Interacting with executive stakeholders (CFO, CCO, CMO).
- Certification: CPC or COC + ROCC or at least experience in RAD ONC
Benefits
- Competitive benefits package
- Annual bonus plan at a target of 5.00%
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