Revenue Integrity and Compliance Analyst

Position Overview

The UCM Revenue Integrity and Compliance Analyst will be a dynamic and self-motivated individual able to provide revenue cycle support to the Revenue Integrity and Compliance Coordinator and Upstate Community Medical (UCM). In addition, the Revenue Integrity and Compliance Analyst will also support other members of the UCM leadership team and participate in the organization and execution of activities with other UCM operations staff.

The Revenue Integrity and Compliance Analyst under the direction of the Revenue Integrity and Compliance Coordinator will independently perform multiple revenue cycle and compliance job duties that require a broad range of skills and knowledge that is highly regulated. The position requires a professional demeanor, the ability to prioritize multiple activities while maintaining a confidential environment. Excellent communication, interpersonal and collaboration skills are essential for this role due to interactions with providers and senior members of the organization as well important external stakeholders.

Tasks, Responsibilities And Essential Functions

• Provide high-level, confidential support to the Revenue Integrity and Compliance Coordinator.
• Provide revenue cycle support for professional billing, coding and compliance.
• Work in collaboration and coordination with Clinical Leadership, Executive Director and leadership team to draft and distribute communications on behalf of UCM to internal and external teams.
• Build a strong working relationship with the UCM team by organizing efficient communication and following up with deadlines and pertinent information.
• Assist in the preparation of business and operating materials and other key presentations for internal and external UCM leadership meetings.
• Assist in the development and maintenance of UCM document and knowledge repositories, websites, and business systems.
• Serves as coding resource for all specialties within UCM practice
• Provides training and education on all new CPT codes and existing codes
• Performs charge capture reviews and supports departments in identifying charging opportunities.
• Assists in conjunction with the Revenue Integrity and Compliance Coordinator compliance plans and reviews
• Assists with monitoring compliance with corporate, Federal, and State guidelines bring forward changes, as applicable, while focusing on accuracy and revenue cycle integrity.
• Performs pre-bill reviews for coding quality and accuracy for each specialty UCM supports and provides education either one-on-one or group setting. This would include review of provider documentation and charge documents.
• Monitors professional charging processes and systems with in-depth knowledge of inpatient and ambulatory charging.
• Ability to understand and analyze payer regulations and impact to the professional chargemaster on reimbursement and coding guidelines
• Conducts internal reviews to improve revenue cycle, claims production and coding integrity
• Demonstrated continuing self-development initiatives, meets established goals and objectives in a timely fashion, participates in developmental opportunities that enhance job performance.
  
  

Qualifications

• Associates Degree preferred.
• A minimum of five (5) years related experience in revenue cycle, billing, coding, and compliance
• Certified Professional Coder or equivalent
• Epic knowledge preferred
• Revenue Cycle Compliance preferred
• Professional billing knowledge preferred
  
  

Licenses

• Certified Professional Coder (CPC)
• Obtain CPC Certification within one year if not currently certified
• Obtain Certified Professional Medical Audit (CPMA) certification within six months
  
  

Knowledge And Skills

• Knowledge of office management systems and procedures.
• Proficiency in MS Office (Excel, Word, Outlook, and PowerPoint)
• Knowledge of clinical settings such as inpatient and ambulatory clinics
• Ability to research coding and regulatory requirements
• Strong analytical skills
• Excellent judgement, discretion, initiative, and ability to maintain strict confidentiality and high ethical standards
• Ability to work independently and balance competing priorities and tight deadlines
• Attention to detail and problem-solving skills
• Excellent time management skills and the ability to prioritize work
• Excellent written and verbal communication skills
• Strong organizational skills with ability to multi-task
• Knowledge of billing, coding, and regulatory compliance
  
  

Job Related Physical Abilities

Must be able to sit for long periods of time, bend, stand, stoop, and perform repetitive motions for use of computers and office equipment. Able to speak and hear sufficient to communication with internal and external customers. Ability to view a computer monitor/screen and enter data. Ability to lift approximately 20 lbs.