What are the responsibilities and job description for the Revenue Integrity Analyst position at Columbia Memorial Hospital?
ELIGIBLE FOR CMH EMPLOYEE REFERRAL BONUS: NON PRIORITY RECRUITMENT
The Revenue Integrity Analyst oversees the daily revenue integrity functions that support accurate charging and billing in order to achieve three critical organizational imperatives: operational efficiency, compliance, and optimal reimbursement/payment. This individual will complete quality control audits and review charge capture clinical workflows for missed revenue opportunities. They will create action plans for capturing missed revenue. Identifies edits in patient management/billing Cerner software that impacts billing accuracy.
Job Requirements
Knowledge of/Skill/Ability to:
- Ability to analyze billing, coding, and financial data to identify discrepancies and trends.
- Attention to detail - High level of precision in reviewing financial documents and clinical records to ensure accuracy.
- Problem-Solving: Strong analytical skills to identify root causes of revenue leakage and implement corrective actions.
- Coding and Regulatory Knowledge: Proficiency in medical coding (CPT, ICD-10, HCPCS), understanding of healthcare billing guidelines and laws & regulations.
- Confidentiality: Ability to handle sensitive patient and financial information in compliance with privacy regulations.
- Time Management: Ability to manage multiple audits, reports, and projects simultaneously.
- Interpersonal Skills: Ability to communicate effectively with diverse teams, including clinical staff, coders, and finance personnel.
- Proficient with Cerner Works, MS Excel, Word, PowerPoint and Pivot Tables.
License/Certification
CHRI Certification required, RHIT Certification preferred
Education and/or Experience
Bachelor’s degree in Healthcare or Business Administration, or a related field.
Must demonstrate knowledge of clinical processes, charge master maintenance, clinical coding (CPT, ICD-10), revenue code, modifiers, charging processes, audits and billing experience.
Physical Demands and Work Environment Conditions / ADA Compliance
Position involves standing, walking, stooping, and occasional carrying and lifting of lightweight materials (up to 20 pounds). May be required to sit for extended periods of time. Requires visual acuity and depth perception to recognize words and numbers; and hand and finger dexterity and hand/eye coordination to use a computer keyboard and common office equipment.
