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Thomas Jefferson University · 4 hours ago

Revenue Integrity Analyst II

Philadelphia, PA

Full-time

Onsite

Mid, Senior Level

5+ years exp

Thomas Jefferson University is dedicated to providing high-quality healthcare and education. The Revenue Integrity Analyst II role focuses on improving the accuracy and integrity of patient charges while collaborating with various departments to analyze billing regulations and ensure compliance with payer guidelines.

Continuing EducationE-LearningEdTechEducationHigher EducationMedicalNon ProfitSTEM EducationTrainingUniversities

Responsibilities

Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson

Primary clinical service-line liaison regarding payor guidelines, explaining regulatory requirements, and ensuring accountability and solid charge workflows for revenue integrity

Serves as the subject matter expert for clinical departments on issues related to revenue cycle

Identifies charge edit trends based on documentation, coding or charging issues and recommends workflow opportunities

Completes focused charge review assessments for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes

Serves as the service-line liaison between Revenue Cycle and clinical department administration regarding revenue, regulatory

Develops processes to modify existing charge capture applications to reduce charge-related claim edits/rejections

Advises service-line leaders and their staff on proper usage of charge codes; identifies opportunities for capturing additional revenue in accordance with payer guidelines

Reviews Charge Description Master change requests for accuracy and appropriateness; approves additions, deletions, and modifications to charges

Prepares revenue cycle meeting materials and facilitates clinical service-line Revenue Cycle department meetings

Collaborates with clinical department personnel to analyze Charge Description Master billing processes and identify root causes for claims issues/rejections; investigates complex issues as necessary; makes recommendations for solutions to management

Assists in the development and implementation of effective chargemaster review, education and training

Qualification

Health Information ManagementCoding GuidelinesRevenue Cycle ManagementCertified Coding SpecialistCharge Capture ApplicationsMedicare/Medicaid RegulationsAuditingCommunication SkillsProject ManagementAttention to Detail

Required

Bachelor's or Associate's degree in Health Information Management, Business Administration, Accounting, Management, Healthcare Administration

Must hold and maintain one or more of the following credentials: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC)

1 – 3 years of experience related to auditing and/or coding is required

Knowledge of Medicare/Medicaid regulations, including billing, coding and documentation requirements

Understanding of various reimbursement systems including IPPS, OPPS and fee schedule

Strong oral and written communication skills

Ability to research, analyze and interpret healthcare policies, billing guidelines, and state and federal regulations

Ability to document clinical workflows impacting revenue cycle

Strong written communication, presentation skills, and excellent customer service skills

Excellent organizational and project management skills

Strong time management, attention to detail, and follow through

Motivated individual who can mentor and inspire in a team environment

Preferred

Applicable professional certifications from American Association of Healthcare Administrative Management (AAHAM) or Healthcare Financial Management Association (HFMA)

Five years experience in a hospital setting or within the healthcare industry strongly preferred