Revenue Integrity Analyst-Health Info Mgt Corp Compliance

UNC Health Care Systems Chapel Hill , NC 27516

Posted 4 months ago

This position may involve support of various hospitals and health care systems within the UNC Health Care System, but will be employed by Rex Hospital, Inc. (this includes, but is not limited to, for purposes of payroll, health benefits, retirement options, and applicable policies). If selected candidate is currently employed with UNC Health Care System, the candidate will remain on current payroll and benefits platform.

The Revenue Integrity Analyst is responsible for researching and resolving complex carrier/payor claim edits, including but not limited to Correct Coding Initiative (CCI), Medically Unlikely Edits (MUEs) and Medically Acceptable Units (MAUs) as well as complex payor denials/audits. Assists with appealing coding denials.

Works with departments on charging and coding issues. They possess claims coding (including modifiers)/reimbursement/billing and compliance skills to access, review and analyze charges and coding to ensure claims are compliant according to payor specifications prior to claim submission.

Bachelor's degree in an appropriate discipline, completion of an accredited Record Technician program or an AHIMA independent study program (or equivalent combination of education, training and experience). Must have one of the following: CCS (Certified Coding Specialist), CPC (Certified Professional Coder), Credentialed as a RHIA (Registered Health Information Administrator), or RHIT (Registered Health Information Technician).

If a Bachelor's degree: Two (2) years of acute healthcare experience with an emphasis on APC/OPPS/IPPS coding, billing, auditing, compliance and/or charge master issues.

If an Associate's degree: Six (6) years of acute healthcare experience with an emphasis on APC/OPPS/IPPS coding, billing, auditing, compliance and/or charge master issues.

If a High School diploma or GED: Ten (10) years of acute healthcare experience with an emphasis on APC/OPPS/IPPS coding, billing, auditing, compliance and/or charge master issues.



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