Revenue Integrity Analyst in Savannah, Georgia at St. Josephs Candler

It is the Revenue Integrity Analyst's responsibility to assist and complete functions/job responsibilities to ensure timely, compliant, and accurate capture of charges and correct claims to various payers including governmental and non-governmental payers. The Revenue Integrity Analyst does this by resolving pre-bill claim edits and Meditech account checks; reviewing and entering accurate charges; completing charge corrections; monitoring, tracking, reporting claims and/or charge capture trends; . The Revenue Integrity Analyst must be knowledgeable and stay current with Centers of Medicare and Medicaid (CMS) regulations and managed care/commercial payer requirements and changes. The Revenue Integrity Analyst must apply billing and coding knowledge to complex claim scenarios in order to resolve those in a compliant, accurate manner. Completes projects and other tasks as assigned by department Director or designee.

Associates Degree - Required (Healthcare Preferred)

Bachelors Degree - Preferred (Healthcare Preferred)

Medical Terminology - Required

Courses in computer technology, spreadsheets/project management, medical billing, and medical coding - Preferred

2 Years hospital revenue cycle charging, claims processing, professional and or hospital healthcare billing, denials management or related revenue cycle/financial experience - Required for candidates with an Associates degree

No Experience Required for candidates with a Bachelors degree or Masters degree in Healthcare Administration, Health Sciences or related healthcare business field of study.

Effective problem solving and attention to detail - Required

Proficient in basic Excel, Word and PowerPoint – Required

Knowledge of hospital billing & claim requirements, charge capture processes, CPT codes, modifiers, and other claims data, electronic record documentation and payer requirements including Medicare guidelines for documentation, charge capture, billing, and claims processing - Preferred

Experience with CPT/HCPCS coding, claims preparation, MUE and NCCI claims edits - Preferred

Certified Professional Coder (CPC) or similar coding certification through accredited organization such as AAPC or AHIMA or Certified Revenue Cycle Professional/Specialist (CRCS) or Certified Revenue Cycle Representative (CRCR) through AAHAM or HFMA respectively – Required or must be obtained within 9 months of hire date.