Senior Analyst Rev Integrity
Senior Analyst Rev Integrity
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Salary Not Disclosed
1 Vacancy
Job Description
The Senior Analyst Revenue Integrity reflects the mission vision and values of Northwestern Medicine (NM) adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.
The Senior Revenue Integrity Analyst will support the Clinical Department and revenue cycle and perform charge capture analysis including annual price increase analysis. The Senior Revenue Integrity Analyst will be responsible for helping maintain the charge master to ensure compliance accuracy and consistency for Northwestern Medicine. The Senior Revenue Integrity Analyst will prepare analysis and support for management and the Clinical Departments.
Responsibilities:
- Perform daily maintenance and quarterly audits of the EAP.
- Prepare necessary files for the EAP database of required department builds.
- Proactively identify charge capture opportunities in all revenue producing departments.
- Research and interpret billing and coding regulations communicate to impacted areas and apply changes that affect policy financial charge capture patient care billing and coding operations.
- Lead quarterly audits on the charge master data elements.
- Review departmental frontend charge capture tools for accuracy.
- Leads complex audits and prepares methodology for annual pricing changes and/or annual coding changes.
- Consistently delivers concrete relevant results. Displays qualities of resiliency and resourcefulness while thinking strategically and practically when problem solving. In addition to results orientation displays business knowledge speed and decisiveness and project management.
- Troubleshoot complex account errors and provides education for resolution to Revenue Manager(s).
- Resolve and answers questions related to charge capture and complex regulatory billing issues. (e.g. ProviderBased status rules OPPS CCI MUE).
- Liaison with Revenue Cycle IT and clinical departments to link EPIC and charge master.
- Research compile and analyze financial data while organizing and maintaining database files for financial modeling.
- Mentors and supports members of Revenue Integrity Team as an informal leader.
- Lead efforts to assess modify and/or develop and implement more timely and consistent processes/systems to increase efficiency accuracy and meaningfulness of information.
- Demonstrates knowledge in computer applications such as knowledge in databases spreadsheets and word processing applications in a high complexity environment.
- Maintain professional and technical knowledge by attending educational workshops reviewing professional publications establishing personal networks adopting and implementing industry best practices and participating in professional societies.
- Supports the finance operations and revenue cycle teams through special projects.
- Protect operations by keeping financial and patient information confidential.
- Supports the finance operation of Northwestern Medicine.
#INDC
Qualifications :
Required:
- Bachelors Degree in Business or related field or 10 years of equivalent experience with progressive advancement.
- Strong communication collaboration and analytical skills
- Proficiency with Microsoft office suite
- 5 years in revenue cycle or revenue integrity role
- Requires critical thinking decisive judgment high attention to detail and ability to work with minimal supervision
- Advanced understanding of CPT HCPCS ICD10 and third party billing requirements
- Extensive knowledge and experience with Medicare/Medicaid regulations
Preferred:
- EPIC Certification (Resolute Charge Capture)
- EPIC Certification (Clarity Report Data)
- Masters degree in Healthcare Management Business MIS Data Analytics or related field
- Beginner to Moderate knowledge of SQL and relational databases
- RHIA preferred or related health care credential (e.g. Radiology technician RN)
Additional Information :
Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age sex race color religion national origin gender identity veteran status disability sexual orientation or any other protected status.
If we offer you a job we will perform a background check that includes a review of any criminal convictions. A conviction does not disqualify you from employment at Northwestern Medicine. We consider this on a casebycase basis and follow all state and federal guidelines.
Remote Work :
Yes
Employment Type :
Fulltime
Employment Type
Remote
