Ambulatory Revenue Integrity Analyst

Primary City/State:

Arizona, Arizona

Department Name:

Ambulatory Revenue Integrity

Work Shift:

Day

Job Category:

Revenue Cycle

A rewarding career that fits your life. Those who have joined the Banner mission come from all walks of life, united by the common goal:

Make health care easier, so life can be better. If changing health care for the better sounds like something you want to be part of, apply today.

Revenue Integrity has become a leading national focus to gain greater visibility for sound financial outcomes/practices, compliance and optimal reimbursement with focus across all continuums of patient care. Revenue Integrity is an integral part of the Revenue Cycle and covers all essentials related to it. We have teams comprised of Charge Capture, Pre-bill, Post-bill and Monitoring (Auditing). RI also utilizes technology to enhance achievement along with an added focus where necessary that may include high dollar accounts, denials, improved A/R days and cash flow while collaborating with many areas such as Billing, Coding, CDM Services Expected reimbursement.

Our Ambulatory Revenue Integrity Team is a small but growing department. You will have the opportunity to work with other revenue cycle partners and have the ability to make a positive impact on the organization.

The Ambulatory Revenue Integrity Analyst is responsible for identifying missing professional charges for all specialties and partnering with coding department for timely revenue capture. Strong analytical skills, ability to work independently and have critical thinking skills. Significant use of Excel, i.e.; concatenate data, formulas, VLOOKUPs, etc.

Monday - Friday Day Shift

This can be a remote position if you live in the following states only: AK, AZ, AR, CA, CO, GA, FL, IA, ID, IN, KS, KY, LA, MD, MI, MO, MN, MS, NH, NM, NY, NC, ND, NE, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WI, WV, WA, & WY

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

POSITION SUMMARY

This position is responsible for managing, coordinating, and implementing charge capture initiatives and processes to improve revenue management and revenue protection. This position is responsible to discover revenue issue root cause and to develop correction action plan and provide charge capture education.

In addition, recommend modifications to established practices and procedures or system functionality as needed to support revenue cycle and manage implementation of the recommended changes. The Revenue Integrity Analyst will work with internal customers to ensure newly implemented workflows and procedures, support revenue cycle integrity and to achieve revenue cycle's financial goals.

CORE FUNCTIONS

1.Reviews facility daily gross revenue reports for variances. Collaborates with department directors/managers to review variances. Escalates variances related to charge capture and collaborates with Revenue Cycle team for process improvements as indicated.

2.Provides concurrent and retrospective charge reviews across Banner facilities comparing clinical documentation to billed charges as directed by Revenue Integrity Manager, Compliance and facility requests. Identify charge capture opportunities, proactively identifying revenue opportunity and suggests improvements.

3.Monitor/Resolve nThrive charge capture work queues to identify opportunities for improvement in charge capture, clinical documentation and system enhancements to improve charge capture. Maintains a current knowledge of coding and documentation requirements as required for compliant billing.

4.Collaborates with Revenue Integrity Senior Manager to develop and generate standardized reporting templates for revenue integrity KPI dashboard and daily/weekly analytics.

5.Analyzes and quantifies all charge capture review results for reporting to departments, CFO and Revenue Integrity Continuous Improvement Forums.

6.Provides guidance and education to departments as a subject matter expert on compliant charge capture and charge reconciliation.

7.Provides education to departments on how to work charge rejection log to ensure all charge are captured to avoid missed revenue and reduce late charges.

8.Coordinate department requested CDM charge additions and deletions as applicable. Partners with Coding, Cerner Clinical Informatics and Revenue Cycle teams to support performance improvement opportunities.

9.Works independently and in collaboration with Revenue Cycle Team under the direction of the Revenue Integrity Senior Manager. Researches complex charging/billing issues and provides education and recommends process improvements to ensure compliant charge capture and reimbursement.

Uses structured work procedures and independent judgment to solve problems and achieve high quality levels. Work output has a significant impact on system business goal attainment. Customers include facility ancillary departments, physicians, nurses, third party payors, central billing staff, and patients/patient families.

MINIMUM QUALIFICATIONS

Must possess a strong knowledge of business and/or healthcare as normally obtained through the completion of an Associate's degree Applied Health Sciences, Finance or health related field.

Requires a level of knowledge normally gained over 2-3 years of related work in the same type of clinical, medical office or acute care unit. Must be knowledgeable of medical terminology and current regulatory agency requirements for coding and charging for the assigned clinical area and have a good understanding of reimbursement methodologies. Requires strong abilities in researching, reading, interpreting and communicating financial data as related to charge capture, effective interpersonal skills, organizational skills and collaborative team working skills.

Must be able to work effectively with Microsoft office software, coding and billing software, Cerner, NextGen and MS4.

PREFERRED QUALIFICATIONS

Preferred licensure includes coding credentials (e.g. CCA, CCEP, CCS, CCS-P, COC, CHC, CHFP, CPC, CRCM, RHIT, etc.).

Additional related education and/or experience preferred.

EOE/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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