Revenue Integrity Analyst

Job Description Summary
The Revenue Integrity Analyst will perform internal quality assessment claim reviews to ensure compliance with federal, payer and internal Revenue Cycle policies to ensure complete, accurate and consistent resolution of claims being held due to edits assigned to Revenue Integrity for resolution, resulting from charging and/or reimbursement and data integrity. The position works to improve the accuracy, integrity and quality of patient charges and to ensure minimal variation in charging practices. The Revenue Integrity Analyst researches claim data variances, evaluates payer updates and assist in the performance of chart-to-bill audits to produce and maintain timely, accurate and inclusive charge capture coding and billing functions. Works to identify charge issues and recommend solutions. The Revenue Integrity Analyst also coordinates and manages several projects simultaneously, reprioritizing when necessary. Identifies the key types of data extraction necessary to create enhanced reports and enrich the analysis from several systems for the purpose of increasing revenue.

Entity
Medical University Hospital Authority (MUHA)

Worker Type
Employee

Worker Sub-Type
Regular

Cost Center
CC002359 SYS - Revenue Integrity

Pay Rate Type
Hourly

Pay Grade
Health-22

Scheduled Weekly Hours
40

Work Shift

Job Description

The Revenue Integrity Analyst will perform internal quality assessment claim reviews to ensure compliance with federal, payer and internal Revenue Cycle policies to ensure complete, accurate and consistent resolution of claims being held due to edits assigned to Revenue Integrity for resolution, resulting from charging and/or reimbursement and data integrity. The position works to improve the accuracy, integrity and quality of patient charges and to ensure minimal variation in charging practices. The Revenue Integrity Analyst researches claim data variances, evaluates payer updates and assist in the performance of chart-to-bill audits to produce and maintain timely, accurate and inclusive charge capture coding and billing functions. Works to identify charge issues and recommend solutions. The Revenue Integrity Analyst also coordinates and manages several projects simultaneously, reprioritizing when necessary. Identifies the key types of data extraction necessary to create enhanced reports and enrich the analysis from several systems for the purpose of increasing revenue.

Additional Job Description

Bachelor’s degree in health administration, business, finance or related field. Three years’ experience in revenue cycle, analytics or reporting required or High school diploma or equivalent plus seven years revenue cycle billing may be substituted for a Bachelor’s degree. Certified Professional Coder (CPC) preferred. Healthcare finance and revenue cycle setting required. Preferred experience with Epic. PC skills including Excel and PowerPoint required. Demonstrated ability to present analytical topics to a clinical audience and/or senior leadership preferred. Excellent communication skills required.

Physical Requirements: Ability to perform job functions while standing. (Continuous) Ability to perform job functions while sitting. (Continuous) Ability to perform job functions while walking. (Continuous) Ability to climb stairs. (Infrequent) Ability to work indoors. (Continuous) Ability to work outside in temperature extremes. (Infrequent) Ability to work from elevated areas. (Frequent) Ability to work in confined/cramped spaces. (Frequent) Ability to perform job functions from kneeling positions. (Infrequent) Ability to bend at the waist. (Continuous) Ability to twist at the waist. (Frequent) Ability to squat and perform job functions. (Frequent) Ability to perform "pinching" operations. (Frequent) Ability to perform gross motor activities with fingers and hands. (Continuous) Ability to perform firm grasping with fingers and hands. (Continuous) Ability to perform fine manipulation with fingers and hands. (Continuous) Ability to reach overhead. (Frequent) Ability to perform repetitive motions with hands/wrists/elbows and shoulders. (Continuous) Ability to fully use both legs. (Continuous) Ability to use lower extremities for balance and coordination. (Frequent) Ability to reach in all directions. (Continuous) Ability to lift and carry 50 lbs. unassisted. (Infrequent) Ability to lift/lower objects 50 lbs. from/to floor from/to 36 inches unassisted. (Infrequent) Ability to lift from 36" to overhead 25 lbs. (Infrequent) Ability to exert up to 50 lbs. of force. (Frequent) Examples include: To transfer a 100 lb. patient that can not assist in the transfer requires 50 lbs. of force. For every 100 additional pounds, assistance will be required from another healthcare worker. 20 lbs. of force is needed to push a 400 lb. patient in a wheelchair on carpet. 25 lbs. of force is required to push a stretcher with a patient with one hand. Ability to maintain 20/40 vision, corrected, in one eye or with both eyes. (Continuous) Ability to see and recognize objects close at hand or at a distance. (Continuous) Ability to match or discriminate between colors. (Continuous) Ability to determine distance/relationship between objects; depth perception. (Continuous) Good peripheral vision capabilities. (Continuous) Ability to maintain hearing acuity, with correction. (Continuous) Ability to perform gross motor functions with frequent fine motor movements. (Continuous) Ability to deal effectively with stressful situations. (Continuous) Ability to work rotating shifts. (Frequent) Ability to work overtime as required. (Frequent) Ability to work in a latex safe environment. (Continuous) Ability to maintain tactile sensory functions. (Continuous) (Selected Positions) *Ability to maintain good olfactory sensory function. (Continuous) *(Selected Positions) *Ability to be qualified physically for respirator use, initially and as required. (Continuous) (Selected Positions)

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!


The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.


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