HOSPITAL REVENUE INTEGRITY ANALYST

JOB SUMMARY:

To facilitate the clarification of clinical documentation of all patients with inpatient status and all observation patients (medical and surgical) through concurrent interaction with physicians, nurses, ancillary, case management, and coding staffs. Works in collaboration with the health care team providing feedback and education to assist the team to improve documentation within the health record to address all conditions, procedures, and care plans to accurately reflect the condition of the patient. The documentation should support appropriate diagnosis assignment, severity of illness, risk of mortality, and reimbursement rules. Additional duties of appeal writing, department reviews, nursing education, and coverage assistance of the Revenue Integrity team. All other duties as assigned.

Minimum knowledge, skills, and abilities:

• Associate or bachelor’s Degree, required
• RN, preferred. (Other clinical experience reviewed if has over 3 years of CDI/Revenue Integrity experience)
• Advanced knowledge of ICD-10, CPT, HCPCS coding in a clinic & hospital environment.
• 1- 2 years auditing and/or documentation improvement with experience speaking in large groups to provide education to physicians and clinical staff.
• CDI or Auditing Certification, preferred. Would be required within 2 years of the start date. (AHIMA/AAPC/ACDIS accepted)
• RHIA, RHIT, CPC or CCS and/or CCS-P Certificate, preferred.
• Knowledge of APGs, DRGs and reimbursement mandates, along with denial management and appeal writing.
• Medicare compliance knowledge.
• Strong written, oral, positive communication and facilitation skills.
• Strong computer knowledge with ability to learn specific coding system, proficiency in Microsoft Word, Excel and PowerPoint.
• Data entry, abstracting, indexing, data collection and statistical-gathering skills.
• Ability to read and communicate effectively in English
• Ability to work effectively as a team member.