What are the responsibilities and job description for the Revenue Integrity Analyst - Berkshire Health Systems, Management Services - Shift: Days, 40 Hours position at BHS Management Services?
The Revenue Integrity Strategist is responsible for auditing and examining of charge capture data and revenue monitoring functions. The role examines the documentation and charges for services rendered based upon government regulations, coding and documentation guidelines, and billing regulations to ensure proper charge capture. Knowledge of inpatient and outpatient billing practices, coding guidelines and CMS Medicare reimbursement methodology a must. This position is responsible to assist in educating on cpt/hcpc definition, along with regulations on the appropriate setting use and documentation of such codes. This position is responsible for assisting operational departments with correction of coding, charging and/or documentation issues, along with providing education to clinical and operational staff. In addition, the position will work closely with the billing department to review denials focused on documentation and coding and analyze for opportunities to eliminate the denials and improve revenue reimbursement through analysis of comparing paid to expected payment. Additionally, this role will provide research and work closely with the senior chargemaster analyst on related revenue topics across BHS to assure the coordination of education and CDM maintenance is aligned. Additionally, this role’s work will monitor the timeliness of charge capture, to minimize downstream late charge rework.
Experience
- Minimum of 3 years working in revenue cycle/revenue analyst role.
- Knowledge of inpatient and outpatient billing practices, coding guidelines and CMS Medicare reimbursement methodology required.
- Strong quantitative, analytical and organizational skills required.
- Experience with Expanse and/or Meditech software.
- Evidence of strong computer skills required.
Education
- BA degree required.
Additional Requirements
- Exceptional communication skills, both written and verbal, and interpersonal relationship skills are required.
- Establishes and maintains effective relationships.
- Proven organizational skills.
- Ability to handle stressful situations calmly and rationally and work under deadline pressures.
- Willing to accept additional responsibilities/duties as position requires.
- Must be self-motivated and able to work with autonomy, possessing skills in problem solving.
- Demonstrates and promotes a culture of continuous improvement.
- Demonstrates experience working in a team-oriented, collaborative environment.
- Proficiency with Microsoft Office, including Excel, Word and Outlook.
Schedule
- Monday-Friday 8 am -4:30 pm
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
