Revenue Integrity Analyst, CDM

Virginia Hospital Center Arlington , VA 22201

Posted 2 weeks ago

Job Details

Certification Preferred

Experience is required

Purpose and Scope:

The objective of the Revenue Cycle Analyst is to assure the accuracy and timeliness of the recognition of patient service revenue in accordance with all applicable laws and regulations. The Revenue Cycle Analyst maintains the integrity of the Service Catalog and supports the Assistant Controller of Budget and Reimbursement to ensure billing accuracy and maximization of revenue.

Responsibilities:

  • Upload new charges, price changes, and other coding changes into the HIS system.

  • Ensure all charge codes load correctly and are accurate

  • Maintain synchronization between the Production and Test database

  • Assist department heads in developing new charges

  • Use Craneware or other software to audit the regulatory compliance of the service catalog

  • Analyze revenue opportunities for the Service Catalog using Craneware software

  • Perform monthly uploads from HIS system to Craneware

  • Perform administrative duties related to Craneware including set-up of new users and testing related to updates and conversions

  • Review CPT, HCPCS and revenue codes with department heads and outside consultants to ensure compliance.

  • Review CEWL daily

  • Analyze CEWL edits and provide feedback and education to departments

  • Develop process documents for charge error resolution

  • Assist the Revenue Cycle Integrity Auditor in reassuring the reimbursements for new procedures.

  • Work with Revenue Cycle Integrity Auditor or Nurse Auditor Senior to provide education to departments regarding appropriate documentation and charging to ensure compliance with billing rules

  • Maintain process documents for revenue integrity procedures

  • Analyze the effect of regulatory changes and amend charging procedures as appropriate

  • Educate departments regarding charge reconciliation procedures and revenue integrity principles.

  • Assist the I.S. System Analysts with conversion or upgrade preparation. To include testing and analysis of revenue; tracing transactions from Charge Entry to Interface to Billing to Financial Accounting.

Requirements:

Education:

  • A college degree or coding Coding Credential (e.g., RHIT, CCS) or equivalent experience is required.
  • A clinical degree or a college degree with a major in accounting, business or health care administration is desired.

Experience:

  • Three (3) to five (5) years of experience with hospital charging, service catalog coding, or equivalent experience.
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Revenue Integrity Analyst, CDM

Virginia Hospital Center