Revenue Integrity Analyst

Job Summary


The Revenue Integrity Analyst is responsible for maintaining a positive, collaborative relationship with their assigned departments', ensuring they are following the charge reconciliation processes and are meeting their key performance indicator metrics.

Essential Functions

• 1. Understands and adheres to the WPH Performance Standards, Policies and Behaviors.
• 2. Ensuring charges are built correctly in the CDM and are appropriately integrated with the clinical charging mechanisms
• 3. Expert on charge capture tools. Auditing and giving feedback as appropriate
• 4. Oversight of Department charges and KPIs, ensuring they are at or above budget and determining root cause if they are not
• 5. Training departments on charge capture tools, rules, regs, CPT/HCPCS/etc. updates and workflows
• 6. Monitor, investigate and resolve revenue integrity concerns and violations reported in their area and provide any necessary follow-ups
• 7. Serve as a resource for organizational and operational revenue integrity issues
• 8. Communicate on CDM maintenance activities.
• 9. Work Revenue Integrity WQs, monitor department WQs. Provide feedback based on WQ volumes, audit outcomes and daily charge statistics
• 10. Validate/test/audit charge triggers to ensure systems are working as expected
• 11. Keep abreast of healthcare industry trends
• 13. Performs all other related duties as assigned

Qualifications

• High School Required or
• GED Required
• 4-6 years 5+ years' experience in a hospital business setting, including full scope revenue cycle and charging Required
• Ability to manage multiple concurrent activities (Medium proficiency)
• Working knowledge of healthcare coding and billing rules and regulations (Medium proficiency)
• Strong analytical and organizational skills (High proficiency)
• Microsoft Office Suite (Medium proficiency)

White Plains Hospital Medical Center is an equal employment opportunity employer. White Plains Hospital Medical Center will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.