Revenue Integrity Analyst

Welcome! We're excited you're considering an opportunity with us!

To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position.

Responsible for data, revenue integrity analysis, and other related efforts to support revenue cycle operations at the enterprise, regional and local business level for provider based coding department. This position is expected to perform analytical work with limited supervision and with full responsibility for various projects and report/data production.

This includes ensuring appropriate reimbursement, compliance and charging with the various coding guidelines and regulatory agencies. This position is an integral part of an overall compliance program effort as it pertains to physician coding and billing functions, as such will interact with physician and non-physician providers to maximize correct coding initiatives. Responsible for analyzing and resolving issues of missing charges and problem accounts by researching information regarding department reimbursement.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1.High School Diploma or Equivalent.

2.Associate's degree in Health Information Management with RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator) OR CCS (Certified Coding Specialist) or CCS-P (Certified Coding Specialist Physician Based), or CPC (Certified Professional Coder).

EXPERIENCE:

1.Four (4) years of medical coding experience.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.

They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1.Collaborates with provider-based related departments to ensure the appropriate ancillary/clinical electronic modules are updated appropriately.

2.Responsible for working, in conjunction with revenue cycle entities, to identify new services or procedures for charge capture opportunities.

3.Works with PB providers, department administrators, and the PB charge master and revenue cycle teams to establish charges according to policy and procedure.

4.Ensures provider preference lists are kept current and compliant, including identification of services no longer performed.

5.Works the Claim Edit and Claim Follow-up WQs, resolving the issues as well as tracking, trending, and reporting trended issues to the appropriate teams or departments for resolution and process improvement to reduce or eliminate the edits, errors, and denials.

6.Performs audits and validations.

7.Processes daily reports.

8.Assists with development of coding related policies, procedures, query development, work queues and training materials in conjunction with management.

9.Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.Must be able to sit for long periods of time.

2.Must have visual and hearing acuity within the normal range.

3.Must have manual dexterity needed to operate computer and office equipment.

4.Must be Able to lift, push or pull 10-20 pounds.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.Standard office environment.

2.Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material.

3.May require travel.

KNOWLEDGE, SKILLS AND ABILITIES:

1.Must possess excellent written and verbal communication skills, as well as interpersonal skills necessary to communicate effectively.

2.Must possess the knowledge of related provider healthcare compliance, revenue cycle operations, and auditing techniques required.

3.Must possess the ability to mentor, educate and train others.

4.Must ensure quality and productivity standards.

5.Must be able to handle high stress and critical situations in a calm and professional manner

6.Must be able to concentrate and maintain accuracy during constant interruptions.

7.Must possess independent decision-making ability.

8.Must possess the ability to prioritize job duties.

9 Must be able to adapt to changes in the workplace and work assignments.

10. Must possess organizational and time management skills.

11 Must possess the knowledge of anatomy, physiology and medical terminology.

12. Must possess analytical and problem solving skills.

13. Must be proficient in office software programs, including medical record and billing systems.

14. Must possess the ability to analyze complex data and reports.

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Day (United States of America)

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

544 UHA Patient Financial Services