Revenue Integrity Analyst at Kootenai Health – Coeur d'Alene, Idaho

Revenue Integrity Analyst

Job Code: 29237

Position Summary

The Revenue Integrity Analyst is responsible for charge reconciliation and analysis of financial data as it relates to regulatory compliant charging and billing guidelines. Under general supervision, this position supports the entire revenue cycle by using clinical expertise and analytical skills to resolve charging and billing issues.

Responsibilities

• Maintains confidentiality of all information related to patients, medical staff, employees, and as appropriate, other information

• Responsible to maintain a working knowledge of the culture and different practices/services as a Multi-Facility department and organization

• Uses clinical, audit and analytical skills to independently conduct reviews of medical record documentation compared to patient charges on a concurrent and/or retrospective basis

• Works closely with charge producing departments and IS and takes initiative in investigating and resolving billing and charging issues

• Provides education to clinical departments on charge entry, accuracy, reconciliation, and compliance

• Independently addresses patient, department, and administrative requests for a variety of issues related to revenue and charge integrity

• Performs analysis on suspected issues to determine root cause and provide correction action plan

• Assists in charging audits, internal charging audit, denials, and external charging audits

• Supports Revenue Integrity team members; responds positively to special projects and responsibilities, including performance objectives

• Performs other related duties as assigned

• Relies on experience and judgment to plan and accomplish goals

• Regular and predictable attendance is an essential job function

• Competent to meet age specific needs of the unit assigned

Requirements and Minimum Qualifications

• Bachelor’s degree preferred

• Coding certification, Certified Healthcare Financial Professional (CHFP) or Certified Revenue Cycle Representative (CRCR) preferred

• Minimum 3 years’ experience in the healthcare industry (such as business office, finance, revenue auditing, coding, etc.) required

• Extensive familiarity with CPT and HCPCs charge codes

• Knowledge of the dynamics of charge accuracy programs

• Strong computer skills including working knowledge of Excel and Word. Ability to adapt quickly to new systems and tools.

• Strong knowledge of hospital and clinic billing requirements, billing systems, payer contract parameters, proration protocols

• Demonstrated experience with process improvement strategies and the development of effective workflows

Working Conditions

• Must be able to lift and move up to 10 lbs

• Must be able to communicate and exchange accurate information

• Must be able to maintain a sitting position

• Typical equipment used in an office job

• Remote eligible