Specialty Care Revenue Integrity Analyst

General Summary and Purpose The Specialty Care Revenue Integrity Analyst will support the Saint Alphonsus Health System Financial Advocate department, which provides revenue integrity support for oncology and outpatient infusion services at all health system sites. The analyst will assist with the development and implementation of policies and procedures, and process improvement projects. The analyst will monitor updates to federal, state and private billing policies and regulations, and provide staff education to department colleagues to mitigate risks to the organization. Employment Type Full time Shift Day Shift Requirements Bachelor's degree required in health science, social work, finance, business, analytics, statistics or other related field. Minimum 3 years of direct experience in revenue cycle or healthcare reimbursement in a hospital or clinical setting required. Certification in healthcare compliance, revenue cycle, revenue integrity or coding preferred. Must be knowledgeable in revenue cycle functions, basic facility coding and billing/collection processes related to oncology and/or non‑oncology infusions. Must demonstrate working knowledge of medical/pharmaceutical terminology, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and ICD‑10 codes. Effective communications skills at patient, provider, and leadership level. Ability to manage and prioritize a variety of complex tasks and patient account issues at the same time, including coordinating work so deadlines are met. Must be able to work in an environment with a high level of activity, distractions, and numerous interruptions. Proficient in MS Office applications. What You Will Do Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions. Works with department leaders to ensure oncology financial navigation policies and procedures are compliant with federal, state and health system guidelines. Supports management by producing complex reports and data analysis to develop, monitor, and meet key performance metrics. Develops training material and coordinates continuing education related to financial counseling, payer policies and pharmaceutical access to enhance professional development for department. Conducts audits on access and reimbursement for specialty pharmaceuticals administered in hospital setting for all health system sites. Knows internal procedures and identifies process improvement opportunities regarding compliance with billing regulations, and assists with implementation and monitoring for consistency and sustainability. Works closely with pharmacy, hospital billing and charge capture to identify potential risk areas and implement processes to avoid future risk. Maintains a working knowledge of existing and proposed regulatory requirements related to hospital and professional coding, billing, reimbursement, and general integrity and compliance matters. Tracks and maintains appropriate documentation related to revenue integrity and other organizational integrity issues as requested or required. Willing to learn various tasks performed by Specialty Care Financial Navigators and assist as needed. Willingly accepts personal responsibility for decisions, actions, attitudes, and behaviors that contribute to the overall effectiveness of the organization. Communicates effectively, follows through on assignments, uses resources efficiently, participates in learning opportunities, and treats others with respect and dignity. Ability to act independently with proven leadership skills. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person‑centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. #J-18808-Ljbffr Trinity Health