Revenue Integrity Analyst
Montefiore Health System Revenue Integrity Analyst
City/State:
White Plains, New YorkDepartment:
Financial Services Patient Accounting_1Work Shift:
DayWork Days:
MON-FRIScheduled Hours:
9 AM-5 PMHours Per Pay Period:
75Pay Rate/Range:
$69,257.57 - $103,897.17
Job Summary
The Revenue Integrity Analyst is responsible for maintaining a positive, collaborative relationship with their assigned departments', ensuring they are following the charge reconciliation processes and are meeting their key performance indicator metrics.
Essential Functions
- 1. Understands and adheres to the WPH Performance Standards, Policies and Behaviors.
- 2. Ensuring charges are built correctly in the CDM and are appropriately integrated with the clinical charging mechanisms
- 3. Expert on charge capture tools. Auditing and giving feedback as appropriate
- 4. Oversight of Department charges and KPIs, ensuring they are at or above budget and determining root cause if they are not
- 5. Training departments on charge capture tools, rules, regs, CPT/HCPCS/etc. updates and workflows
- 6. Monitor, investigate and resolve revenue integrity concerns and violations reported in their area and provide any necessary follow-ups
- 7. Serve as a resource for organizational and operational revenue integrity issues
- 8. Communicate on CDM maintenance activities.
- 9. Work Revenue Integrity WQs, monitor department WQs. Provide feedback based on WQ volumes, audit outcomes and daily charge statistics
- 10. Validate/test/audit charge triggers to ensure systems are working as expected
- 11. Keep abreast of healthcare industry trends
- 13. Performs all other related duties as assigned
Qualifications
- High School Required or
- GED Required
- 4-6 years 5+ years' experience in a hospital business setting, including full scope revenue cycle and charging Required
- Ability to manage multiple concurrent activities (Medium proficiency)
- Working knowledge of healthcare coding and billing rules and regulations (Medium proficiency)
- Strong analytical and organizational skills (High proficiency)
- Microsoft Office Suite (Medium proficiency)