Revenue Chrg Intgrty Analyst

Job Summary

The Charge Integrity Analyst is responsible for a wide variety of charge-related functionality and departmental support. Analysts maintain the hospital and professional charge master and hospital fee schedules. In addition, Analysts are required to remain current on regulatory charging updates, review and revise rates annually, and analyze charging issues.

Analysts are assigned to support a series of charge sources. Throughout the year, the analyst will assist departments with new charge build and resolving charging issues. Analysts monitor and work numerous work queues in Epic, recommend rule changes, and implement charge capture workflow optimizations. Analysts work with a large variety of Revenue Cycle and non-Revenue Cycle teams and individuals to support charge capture functionality and ensure proper charging practices.

Projects are assigned to ensure proper build, testing, training, and monitoring of system upgrades and optimizations related to their departments. Analysts are expected to work closely and promote an atmosphere of teamwork with other members of Charge Integrity as well as their peers in Revenue Cycle, to achieve department objectives and provide stellar customer service.

This position will be providing charge integrity analytics to our UMH-West location.

Mission Statement

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Responsibilities*

• Ensure the Charge Master is built and maintained the in accordance with hospital policies, AMA guidelines, Federal and State law and National Uniform Billing Committee standards. Stay current with CMS and other regulatory and payor mandated charge capture guidelines, including revenue code, CPT, HCPCS, and modifier changes.
• Learn and utilize the appropriate tools to maintain Charge Master data.
• Maintain current knowledge through reading pertinent articles, newsletters, memos, and attending seminars as needed to successfully oversee the Charge Master and ensure its proper use.
• Work with appropriate teams, committees, and personnel to maintain the following:
  • HB and PB Chargeable, Orderable and Performable (EAP)
  • Hourly and Daily Bed Charge Billing Table (BCB)
  • Cost Center Assignment Table (CCAT) and Cost Center Table (BCC)
  • Epic Rules (Router, Claims Manager, Revenue Guardian, etc.)
  • Fee Schedules
• Following department policy, use standardized pricing algorithms, available benchmarking and other rate setting tools to set hospital rates.
• Learn departmental systems and workflows that interface with and/or support charge capture.
• Assist in developing and establishing new departments (including the build of their charges and charge capture and revenue routing and reconciliation tools).
• Work with Clinical Departments, Revenue Cycle peers, and other Epic teams to ensure proper charge generation from clinical systems.
• Provide support as needed to Finance and other Revenue Cycle departments.
• Participate in the design, build, and testing of new Epic work queue rules that track and identify potential charge errors.
• Monitor and work assigned Epic work queues on a timely basis, coordinating and communicating to external partners when assistance is needed with charge corrections.
• Participate in design, build, test script development, testing, training and go-live support of periodic Epic upgrades, new module implementations, system optimizations and other organizational projects.
• Maintain accurate records of all charge and fee schedule changes, including all critical correspondence pertinent to those changes.
• Act as liaison between Billing and clinical departments to investigate and resolve issues.
• Run routine and ad hoc reports, providing analysis and distributing reports as needed.
• Participate in continuous process improvement activities, identifying and supporting process change.
• Other projects and ad hoc reports as assigned.

Required Qualifications*

• Associate's degree in Business Administration, Health Administration, Health Information Management, Health Information Technology, Nursing or equivalent combination of education and work experience.
• Experience with facility reimbursement, coding process and compliance concerns related to a charge master.
• Experience as a Certified Coder, Charge Master Administrator, Revenue Integrity Specialist, Epic Analyst or Senior Biller with government payers or equivalent combination of experience.
• Demonstrated problem solving, analytical and organizational skills.
• Demonstrated ability to research root cause and recommend solutions.
• Extensive experience with Electronic Health Record clinical and billing workflows (such as Epic or Cerner).
• Extensive experience with MS Office tools with strong emphasis on advanced Excel knowledge.
• Self-starter and detail oriented with the ability to work well independently.
• Excellent communication with the ability to articulate both written and verbal communication(s).
• Strong customer service focus.
• Great attendance record.

Desired Qualifications*

• Bachelor degree in Business, Health Administration, Nursing or equivalent combination of education and experience.
• RHIT, Coding certification or equivalent combination of education and experience.
• Experience with University systems including, Epic EHR (Epic), Toad DataPoint/Hyperion IR, DataMart, Outlook, payer websites.
• Proficiency in Microsoft PowerPoint, Access, Visio.
• Hospital Billing experience within the last 5 years of this posting.
• Knowledge of University Health System policies, procedures and regulations.
• Knowledge of or experience in the delivery of patient care and front-end workflows.
• Experience performing financial and billing data reviews; claim and medical record reviews; analyzing documentation, identifying areas of financial risk and potential.
• Experience interpreting and applying CMS and other third-party payer guidelines and regulations.

Modes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Background Screening

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Application Deadline

Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled any time after the minimum posting period has ended.

U-M EEO Statement

The University of Michigan is an equal employment opportunity employer.

261370

Revenue Chrg Intgrty Analyst

Revenue Chrg Intgrty Analyst

Michigan Medicine - Ann Arbor

Mobile/Remote

Full-Time

Regular

Exempt

Exec Vp Med Affairs

MM Rev Cycle (PTO)

3/18/2025 - 4/01/2025

Finance