Revenue Integrity Data Analyst I (Hybrid)

Job Requirements

Under direct supervision, identifies charge capture improvement opportunities and works collaboratively with Revenue Integrity team members to support annual Revenue Cycle initiatives and priorities. Recognized as a developing HSCRC and clinical service line subject matter expert. Works with clinical department managers and staff to ensure process improvement changes are understood and to ensure the charge capture process is yielding expected outcomes. Serves as a conduit between clinical departments and Revenue Integrity. Facilitates implementation of standardized processes, and is accountable to support efficient and effective charge capture outcomes.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Updates the charge master files, including HSCRC price changes, as directed. Researches various HSCRC and/or CMS inquiries as requested. Completes tasks associated with HSCRC RVU taskforce conversion meetings, such as meeting notes and populating templates as instructed.

2. Attends cross-functional (e.g. with clinical departments, IS&T, or clinical informatics) meetings with more senior analysts to understand required changes to ancillary and application charge capture tool(s). Through detailed directions and documented processes, updates tools and carries out routine integrity checks.

3. Ensures departmental communications are distributed to all stakeholders.

4. Obtains basic knowledge and understanding of all charge processes within the organization and provides oversight to clinical informatics staff and application analysts who assist other department managers/directors with determining compliant charge capture workflows, including updates to clinical charge capture tools.

5. Review work queue lists daily and contact appropriate owners to ensure held charges are being worked timely. Assists with the ensuring resolution of accounts in work queues, erroneous or missing charges, and researches coding, documentation, and coding guidance. Investigates charging issues and suggests possible solutions for the resolution of charge capture issues.

6. Collects and documents business operations and workflows in support of CDM discovery sessions. Summarizes findings and assists with the completion of necessary CDM documentation.

7. May participate in hospital and HSCRC meetings as an observer. Responsible for understanding CDM-related decisions regarding pricing, CDM concepts, HSCRC methodology, and select reimbursement concepts as it applies to specific service lines.

8. Under direct guidance from more senior team members or management, prepares various revenue-related reports from multiple sources and Epic workbench reports to support hospital operations.

9. Runs reports under direct guidance from more senior team members or management in support of audits. Clearly summarizes results and findings.

10. Assists with system/process setup for new services by conducting discovery, build, and testing during sessions facilitated by Revenue Cycle and IS&T leadership related to assigned service line(s).

11. Under direct guidance, prepare CDM Epic build changes related to assigned service line(s).

Work Experience

Education and Experience


1. Bachelor's Degree in Healthcare, Finance, Accounting, or equivalent related subject is required.

2. Epic CDM Proficiency certification must be obtained within 12 months of hire and maintain Epic new version training requirements on an ongoing basis.

Knowledge, Skills, and Abilities

1. Proficient in preparing and analyzing financial data and implementing changes.

2. Effective time management skills.

3. Effective interpersonal skills to build collaborative relationships with team members and customers.

4. Strong organizational and problem-solving skills.

5. Effective verbal and written communication skills are necessary.

6. Effective computer skills that include the following applications: MS Excel, MS Word, and PowerPoint.

7. Ability to handle confidential issues with integrity and discretion.

8. Ability to work effectively in a fast-paced work environment.

Working Conditions/Physical Demands

1. Position may require a flexible work schedule, including night and weekend support of major implementations or major system support efforts.