Revenue Integrity Analyst

Description

Job Schedule: Full Time

Standard Hours: 40

Job Shift: Shift 1

Shift Details:

Work where every moment matters.

Every day, over 38,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.

With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

Position Summary:

The Revenue Integrity Analyst serves as an integral part of both revenue optimization and compliance within the organization through leveraging an integrated, Epic based EMR to assist in the identification, reporting and resolution of any issues stemming from or with charge capture processes for both hospital and professional outpatient services. This role services the HVI Cardiology institute as this area is growing in size, technology requiring additional dedicated support as it relates to all elements of the revenue cycle, ensuring the financial success of these institutes. The role services both the professional and hospital services as it relates to procedural services. Through the use of data, system reports, and analytics, this role will support the charge capture and accuracy efforts. This position will help to optimize revenue cycle processes by validating, evaluating, and trending large amount of data for presentation to all levels of the organization. This position also serves as technical support for Revenue Integrity staff, Revenue Cycle Departments.

Position Responsibilities:

Key Areas of Responsibility

1. Evaluates current charging and coding structures and processes in revenue generating departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements. Assesses the accuracy of all charging vehicles, including clinical systems and dictionaries, encounter forms and other charge documents used to capture revenue

2. Analyzes denial data to identify root causes of preventable denials, develop and implement corrective action plans to address root causes, including collaborating with the clinical areas as well as other departments within revenue cycle. Optimizes revenue cycle processes by validating, evaluating, and trending large amount of data for presentation to all levels of the organization

3. Performs regular charge audits, identifying any trends, and implementing corrective actions when appropriate. Document findings and corrective actions reporting to the Revenue Integrity Manager.

4. Provides guidance, communication and education on correct charge capture, documentation, coding and billing processes.

5. Lead annual, quarterly, CPT, HCPCS changes for accuracy, compliance with applicable billing guidelines, and optimization of reimbursement

6. Communicate CDM maintenance activities to clinical departments and information systems staff to implement necessary changes that affect charge identification, capture, reconciliation, and claim processing. Ensure changes within the charge description master (CDM) coincide and are implemented with clinical systems by reviewing flow sheets or charge capture preference lists.

7. Monitor national, state, and local information to keep current with applicable regulatory and legislative changes and tailor the revenue integrity program accordingly.

8. Leads and participates in projects and other duties related to revenue cycle initiatives and duties. Includes training new analysts.

Working Relationships

Job Title of Individual(s) Reports To: Manager, Revenue Integrity Analyst

Qualifications

Education

• Minimum: Bachelor's Degree or equivalent Healthcare experience of 10 yrs.

• Preferred: Associates degree with health management or financial emphasis and/or health services or ten (10) years of healthcare work experience.

Experience

• Minimum: Three to four years of progressive on-the-job experience in an acute care hospital

• Preferred: Five (5) years in hospital-based health care setting with experience in facility revenue cycle operations

Licensure, Certification, Registration

Certified Coder, (CCS, CPC, etc.)

Language Skills

English - Strong written and verbal communication skills

Knowledge, Skills and Ability Requirements:

Extensive knowledge of:

• ICD‑10-CM diagnostic and CPT/HCPCS procedure codes

• Clinical information related to responsibility areas

• Microsoft Office Products; Word, Excel

Skills:

• Read, write and speak English proficiently.

• Strong analytical capabilities.

• Excellent organizational skills.

• Proficiently read and interpret physician writing.

Strong ability to:

• Function independently.

• Handle multiple priorities.

• Listen and acknowledge ideas and expressions of others attentively.

• Converse clearly using appropriate verbal and body language.

• Collaborate with others to achieve a common goal through mutual cooperation.

• Influence others for positive and productive outcomes.

• Utilize coding subject matter expertise to support new specialized coders and other projects.

• Work across the Hartford HealthCare System.

We take great care of careers.

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.